Open House and Give the Coalition’S 9-1- the Event

Active Shooter Mechanism Of Injury NAVIGATOR 2013 Assailant kills two at MOI key to determining Welcome to the busy shopping mall likely internal injuries kingdom of dispatch The International Academies of Emergency Dispatch March | April 2013 TheJournal JournalOf Emergency Dispatch

Sandy takes East by storm Calls swamp lines

iaedjournal.org

g industry insider 11 | National news 16 | International news

g departments BestPractices 17 | NAVIGATOR Rewind 18 | 9-1-1 Education 21 | ACE Achievers 23 | FAQ features 24 | NAVIGATOR 26 | Hell And High Water OnTrack Calls from the stranded, sinking, or suddenly 33 | Medical CDE sunk flooded the lines as Hurricane Sandy Understanding mechanism of blew its way along the Eastern Coast. injury is vital to pre-hospital care. 36 | Police CDE 30 | Shooting Spree Caller in Danger Protocol puts safety first. Dispatchers at the Clackamas County Comm. Center jumped into action at reports of an YourSpace active shooter at the county’s largest mall. 40 | Dispatch In Action 42 | Off Hours

Correction The Medical CDE quiz in the November/December 2012 Journal (She’s Having A Baby) included a question that will not be counted as either correct or incorrect. The question (#2) suggested that the MPDS® was designed to handle any possible situation or scenario related to childbirth and pregnancy. While the MPDS was developed to guide EMDs through many probable situations, no protocol is designed to handle all situations. The editors apologize for any confusion this error may have caused.

The following U.S. patents may apply to portions of the MPDS or software depicted in this periodical: 5,857,966; 5,989,187; 6,004,266; 6,010,451; 6,053,864; 6,076,065; 6,078,894; 6,106,459; 6,607,481; 7,106,835; 7,428,301; 7,645,234. The PPDS is protected by U.S. patent 7,436,937. FPDS patents are pending. Other U.S. and foreign patents pending. Protocol-related terminology in this text is additionally copyrighted within each of the NAED’s discipline-specific protocols. Original MPDS, FPDS, and PPDS copyrights established in September 1979, August 2000, and August 2001, respectively. Subsequent editions and supporting material copyrighted as issued. Portions of this periodical come from material previously copyrighted beginning in 1979 through the present.

The g dearreader JournalOf Emergency Dispatch INTERNational InterNational Offices Sun Will Shine Academies of AUSTRALASIAN OFFICE emergency dispatch 011-61-3-9806-1772 110 South Regent Street, Suite 800 CanadIaN Office Come to Salt Lake City, UT 84111 USA 1-514-910-1301 USA/Canada toll-free: 800-960-6236 EUROPEAN OFFICE Int’l/Local: 801-359-6916 011-43-5337-66248 NAVIGATOR; Fax: 801-359-0996 ITALIAN OFFICE www.emergencydispatch.org 011-39-011-1988-7151 [email protected] Malaysian Office 011-603-2168-4798 stay to visit sights U.K. OFFICE 011-44-0-117-934-9732

IAED JOURNAL staff Audrey Fraizer, Managing Editor Communications | creative Director Graphic Designer Kris Christensen Berg Reeding Roberts Managing Editor production manager he views of the Academy’s skies should be blue, rather than Audrey Fraizer Jess Cook Technical Editor web | multimedia manager new building from the air slate gray, and the Academy’s Brett A. Patterson Erwin Bernales might be something many building should be a lovely sight SENIOR EDITOR Web Designer T James Thalman Jason Faga do not have the opportunity to see. from any perspective. The best copy Editor International Translators Heather Darata Ammar Almshab Ana Corona And with so much to see from views are from the east-facing Assistant Editor Giuditta Easthope Cynthia Murray Yardane Niessink below or inside, the view from the windows, and maybe I’m biased SENIOR Designers Nadine Schick Chris Carr Sara Scott top may be irrelevant. because it’s the view I see from Carolyn Turcotte Lee Workman Recently, though, it was a sky where I sit. But, let’s be honest, Boards & Councils view two people were trying to a background of mountains is Accreditation Board Chair Jaci Fox (Police/EPD Board) Brian Dale Susi Marsan (ETC) capture on a windless, cold, and— something everybody appreci- Alliance Board Chair Research Council Chair Keith Griffiths Brett A. Patterson due to Salt Lake City’s nasty ates no matter how long a per - Certification Board Chair Standards Council Chairs Pamela Stewart Marie Leroux (Medical/EMD) inversion—hazy afternoon in Jan- son lives here. Gary Galasso (Fire/EFD) ™ Curriculum Council Chairs Tamra Wiggins (Police/EPD) Victoria Maguire (Medical/EMD Board) uary. PDC Regional Account The new headquarters of Mike Thompson (Fire/EFD Board) Manager Dixon Brown snapped the International Academies of Academy Staff stills from a camera while PDC Emergency Dispatch® (IAED™) President Communications Director Scott Freitag Kris Christensen Berg Senior Graphic Designer Chris is a focal point in a downtown Associate Director | USA Director of european relations Carlynn Page Tudy Benson Carr kept another camera roll- attracting an international rep- Associate Director | U.K. international liaIson ing for a live feed. utation and flair. We are steps Beverley Logan Amelia Clawson Associate Director | Australasia MemberSHIP SERVICES manager The helicopter buzzing away from an outdoor shopping Peter Hamilton Arabella VanBeuge Academics & Standards Associate around the nine-story building in mall designed to complement Brett A. Patterson downtown Salt Lake City raised a the landscape and within walk- College of fellows few eyebrows. It did mine. I was ing distance of numerous muse- Chair Thera Bradshaw (CA) (Emeritus) Marc Gay (Emeritus) Geoff Cady (CA) walking toward the office when I ums, theaters for symphony and Steven M. Carlo (NY) Australasia | South America Jeff Clawson, MD (UT) Frank Archer, MD (Australia) Phil Coco (CT) noticed the helicopter approach- dance, city parks, and a night Andrew K. Bacon, MD (Australia) Brian Dale (UT) Peter Lockie (New Zealand) Chip Darius, MA (CT) ing downtown from the Wasatch life you might be surprised to Peter Pilon (Australia) Kate Dernocoeur (MI) Canada Norm Dinerman, MD (ME) Mountains to the east. My first find here. Drew Burgwin (Br. Columbia) Patricia J. Dukes, MICT (HI) Claude Desrosiers (Québec) James V. Dunford, MD (CA) Douglas Eyolfson, MD (Manitoba) Marc Eckstein, MD (CA) guess was a helicopter ferrying The scenery is our crown Martin Friedberg, MD (Ontario) John Flores (CA) Marie Leroux, RN (Québec) (Emeritus) Scott Freitag (UT) people from a ski resort or tour- jewel! Downtown is less than an Mark Gay, (Québec) (Emeritus) Gary Galasso (CA) Paul Morck (Alberta) Keith Griffiths (CA) ists getting a birds-eye view of our hour’s drive from an afternoon Wayne Smith, MD (Québec) Jeffrey R. Grunow, MSN (UT) Darren Judd (UT) Europe Alexander Kuehl, MD, MPH (NY) (Emeritus) city and the Wasatch Mountains. of mountain adventure. A cam- Andre Baumann (Germany) James Lake (SC) Gianluca Ghiselli, MD (Italy) James Lanier (FL) Whatever the reason, I envied era is essential equipment. Aside Jean-marc Labourey, MD (France) Bill Leonard (AZ) Jan de Nooij, MD (Netherlands) Stephen L’Heureux (NH) Gwyn Pritchard (Cyprus) (Emeritus) Victoria A. Maguire (MI) the people flying above our drab from the scenic beauty, you never Bernhard Segall, MD (Austria) Sheila Malone (IN) Gernot Vergeiner (Austria) Susi Marsan (GA) winter inversion. know when you might stumble Christine Wägli (Switzerland) Robert L. Martin (DC) Dave Massengale (CA) United Kingdom | Ireland Jim Meeks, PA-C (UT) The inversion literally puts a across a moose or mountain goat. Trevor Baldwin (England) Shawna Mistretta (CO) Michael Delaney (Ireland) Gene Moffitt (UT) lid on the cold air pooling in our I hope that you take the Conrad Fivaz, MD (England) Jerry L. Overton (UT) Louise Ganley (England) Eric Parry, ENP (UT) James Gummett (England) Rick W. Patrick (PA) urban bowl. Fog and low clouds opportunity to see more of Salt Chris Hartley-Sharpe (England) Brett A. Patterson (FL) Andy Heward (England) Paul E. Pepe, MD, MPH (TX) add to the jumble; visibility suf- Lake City and its breath-taking Stuart Ide (England) Ross Rutschman (OR) (Emeritus) Peter Keating (Ireland) Joe Ryan, MD (NV) Ray Lunt (England) Doug Smith-Lee (WA) fers and emissions from cars and outdoor venues during your stay Andy Newton (England) (Emeritus) Tom Somers (CA) John D. Scott, MD (England) Paul Stiegler, MD (WI) buses, fireplaces, and industry for the annual NAVIGATOR Janette K. Turner (England) Michael Thompson (UT) Carl C. Van Cott (NC) makes your eyes water (to say conference. We are a state of United States Sheila Q. Wheeler, MSN (CA) Bill Auchterlonie (KS) Craig Whittington (NC) Robert Bass, MD (MD) Arthur H. Yancey, II, MD, MPH (GA) the least). The colder the tem - diversity, with a future that pre- Christopher W. Bradford (FL) Tina Young (CO) peratures, the more gunk accu- serves our natural beauty in the mulates, and when conditions climb to accommodate an inter- The Journal of Emergency Dispatch is the official bimonthly publication of the International Academies of Emergency Dispatch® (IAED™), a non-profit, standard-setting organization promoting safe and effective emergency dispatch services are inversion ideal, the beauty of national audience. worldwide. Comprised of three allied academies for medical, fire, and police dispatching, the IAED supports first-responder-related research, unified protocol application, legislation for emergency call-center regulation, and strengthening the Salt Lake City gets lost in the fog. Hopefully, there will come a emergency dispatch community through education, certification, and accreditation. General IAED membership, which includes a Journal subscription, is available for $19 annually, $35 for two years, Fortunately, by the time day when it’s no longer bad air or $49 for three years. Non-member subscriptions are available for $25 annually. By meeting certain requirements, certified membership is provided for qualified individual applicants. Accredited Center of Excellence status is also available NAVIGATOR rolls around, the stealing some of that breath. g to dispatch agencies that comply with Academy standards. © 2013 IAED. All rights reserved.

THE JOURNAL | March/April 2013 5 g President’sMessage End Of The World It’s a matter of perspective

Scott Freitag, IAED President

est assured, I am thrilled the world Six years ago, on Feb. 12, 2007, a gun - The protocol addresses random attacks kept spinning on Dec. 21, 2012, man killed five people and wounded four initiated by active and unknown assailants Rdespite doomsday prophecies to others at Salt Lake City’s Trolley Square typically occurring at venues giving shooters the contrary. Earth did not fall into a mas - before he was shot dead by police. Simi - the access to a potentially large number of vic- sive black hole, and we were not tossed lar to recent mass shootings, the assailant tims. The IAED developed the protocol with into space from a reversal of the planet’s claimed no apparent motive. He simply the assistance of the National Tactical Officers magnetic poles. turned his unsettling world into a night - Association, and in connection with PPDS The world is still revolving around the mare for the rest of us. users from California; Colorado; New York; sun, in case you hadn’t noticed. While I don’t believe we can eliminate Maryland; Florida; North Carolina; Washing- In fact, I can’t recall anything unusual these types of events, there are ways com - ton, D.C.; Canada; and the United Kingdom. prompting me to think, “Gee, I guess the time munication centers can help minimize Protocol 136 cannot stop a random has come. It’s a shame the new public safety the impact. In December 2012, the Inter - shooter anymore than Medical Protocol complex isn’t completed.” national Academies of Emergency Dis - can prevent sudden cardiac arrest or Fire Although the Maya never, ever said Protocol can preclude the ambush of fire - anything about the world ending at any fighters responding to a burning building, time—according to Mayan Hieroglyph - such as what happened on Christmas Eve ics Expert David Stuart—the concept was in New York City. embraced, perhaps, by those hoping for an But what the protocol can do is mitigate early out or an excuse for excessive winter the active situation. Pre-Arrival Instructions solstice celebrations. (PAIs) within the Key Questions ready the I don’t personally know anyone con - caller for possible escape and, when that’s sumed by apocalyptic fears. I’ve read how the not possible, direct him or her to take cover prophecy affected some countries, prompt- in a confined space with further instruc - ing in China, for example, panic purchasing tions to safeguard the space from the shoot- of candles and survival kits and the building er’s continued assault. of concrete bunkers. In the U.S., overspend- Importantly for responders, the instruc- ing, panic, and trepidation are all part of the tions can prevent a panicked caller from holiday season, making it nearly impossible making the situation worse; the caller’s to distinguish the reason why people might answers to the dispatcher’s questioning helps have been worked up. prepare responders for the emergent and Maybe it’s the tension of our times or the ever-changing scene. anxiety of a potentially devastating event out- patch® (IAED™) released a cardset version More about the protocol will be available side of our control. The electronic news world of its newly completed Active Assailant at NAVIGATOR 2013, which the IAED is makes it likely for us to read about tragedies as (Shooter) Protocol. Protocol 136 is part of hosting in Salt Lake City. they unfold: the killing of students and staff the upcoming version 4.1a of the Police Pri- Opportunities to learn the inside story at the Sandy Hook Elementary School in ority Dispatch System™ (PPDS®). about the police, fire, and medical proto - Newtown, Conn., and the shooting just days Protocol 136 can be used by all com - cols and their real-life application by other before at the Clackamas Town Center in Ore- munication centers whether or not they agencies are major benefits of attending the gon, resulting in the deaths of two adults and are licensed PPDS ®, FPDS ®, or MPDS ® annual conference. Given the Earth is still serious injury to a teenage girl. In the summer users. IAED Co-founder Dr. Jeff Clawson rotating to the east, as it should, and still in prior to these incidents, a gunman fatally shot made the decision based on the immediacy the shape of a bulging sphere, NAVIGA - 12 people and wounded another 58 in a crowd between events and the overwhelming TOR will also give Salt Lake City the per - attending a midnight movie premiere of The possibility similar events will occur. The fect audience for introducing its new public Dark Knight Rises in Aurora, Colo. We could lead-time gives agencies the opportunity safety building. Seeing that I’m the interim chose not to read the stories, but the accessibil- to provide training and assess their con - director of Communications, if that doesn’t ity makes them hard to ignore. tingency plans should this event occur in happen, the thought of the world ending Utah is no stranger to mass shootings. their jurisdictions. isn’t so bad after all. g

6 THE JOURNAL | iaedjournal.org g ASKDOC Response Time Issues When is time of the essence for the patient?

Jeff Clawson, M.D.

Dr. Clawson: • Strangulation • Electrocution and lightning strikes My boss, Council member John Sharp of • Suffocation • Carbon monoxide poisoning the City of Kansas City, Mo., is looking into response time issues for our city. Could you • Underwater • Unconscious patient with uncontrolled provide me with your definition of ECHO • Complete airway obstruction in choking airway calls? Also, would you be able to send me ECHO was differentiated from DELTA I am also attaching the section in the some examples of life-threatening events to encourage the local assignment of the textbook, “Principles of Emergency Medi- where time is of the essence for the patient. absolute closest responder of any trained crew cal Dispatch” titled “Understanding ECHO Thank you in advance for your response. (i.e., police with AEDs, fire ladder or snorkel Determinant Practice” (pages 3.12–3.16). Araceli B. Gallegos crews, HAZMAT, or other specialty teams Let me add that in the vast majority of Assistant, City Council Office not in the usual medical response matrix). 9-1-1 medical cases, time is not a significant Kansas City, Mo., USA It is important to understand that a factor and these cases should not involve patient given an ECHO-level designa - response of multiple vehicles or the use Dear Ms. Gallegos: of lights-and-siren (HOT response). The As a member of the Council of Stan - ALPHA- and BRAVO-level calls do not dards for the International Academies of ECHO creates require ALS (paramedic) responders, and Emergency Dispatch® (IAED™) and inven- an earlier point ALPHA, and many BRAVO and CHARLIE tor of the Medical Priority Dispatch System™ calls do not require a HOT response. (MPDS®), I would be very happy to do so. I of response for The MPDS first created 33 years ago was very much respect the many public safety designed to give a medically correct orderli- people from Kansas City I have known and those obviously ness to EMS response—not just sending every- worked with over the past 40 years. one to everything, always—and in a big hurry. ECHO level is based on the initial EMD “dying right now.” The MPDS has been proven over time to do recognition of extreme conditions of breath- what the priority levels were designed to ing—especially in those patients whose tion does not necessarily require a different do—send the right thing, to the right patient, breathing is INEFFECTIVE. The MPDS response from DELTA, but encourages the at the right time, at the right speed, and do defines INEFFECTIVE BREATHING as: “ethical” response of other specialty crews or appropriate things over the phone to help The following descriptions, when volun- responders, who otherwise might be sitting the caller and patient, until the troops arrive. teered by the caller at any point in the early close by while someone dies. From a city management viewpoint, interrogation period (Case Entry Protocol): Therefore, ECHO creates an earlier point the MPDS, now in over 2,900 communica- • “Barely breathing” of response for those obviously “dying right tion centers in 43 countries, has never been now,” as well as sending potentially closer involved in a formal lawsuit in those 33 years! • “Can’t breathe” or “Can’t breathe at all” responders that don’t ordinarily go on less It does what it says it will do, if used very • “Fighting for air” urgent medical responses. compliantly and completely. In addition to ECHO, there are certain I hope this helps you. If you have any • “Gasping for air” DELTA events that are more serious (timewise) more questions, please feel free to contact • “Just a little” than others. They could basically be defined as either the International Academies of Emer- • “Making funny noises” what we call “Time/Life Priorities,” such as: gency Dispatch or me at any time. I would • Critical central trauma be happy to talk to you or the councilman if • “Not breathing” that would help and we would be happy to • “Turning blue” or “Turning purple” • Uncontrolled arterial bleeding be involved in further informing the city as And/or when the following conditions exist: • Partial obstructed airway (incomplete to the correct use of the MPDS. choking) Best regards… Doc • Not breathing at all Jeff Clawson, M.D. • High risk delivery conditions: breech, pro- Chair, Rules Committee • Breathing uncertain (agonal) lapsed cord, shoulder dystocia, 3rd trimes- Council of Standards • Hanging ter bleeding IAED/NAED™ g

THE JOURNAL | March/April 2013 7 g academyresearch Breathing Problems Research zeroes in on oft-used protocol

Tracey Barron

study published almost five years ago immediate upgrade to the response mode In comparison, a patient with asthma (Sept/Oct 2008) in Prehospital Disas- due to the cardiac arrest potential of patients experiencing abnormal breathing but with- Ater Medicine (PDM) looked at the within these subgroups experiencing severe out the other signs and/or symptoms was potential of Protocol 6: Breathing Problems for respiratory distress. not as likely to suffer a cardiac arrest. distinguishing between minor or non-critical The subsequent study looking at breath- In conclusion, a prioritization scheme conditions from conditions posing greater risk ing problems (PDM, August 2012) exam - accounting for the presence of either single to the patient and, consequently, determining ined combinations of Key Questions (KQ) or multiple signs and/or symptom combi- the appropriate level of care required on scene in MPDS Protocol 6 to discover optimal KQ nations for Protocol 6: Breathing Problems and, if necessary, during transport.1 combinations for immediate identification helps to better define DELTA-level cases in Considering Protocol 6 was among the of potential cardiac arrests in calls involving the MPDS. most commonly used protocols at the time breathing problems. What does this mean to you and your in the communication center, it only makes Data analyzed for the retrospective communication center? sense that this protocol is also among the study was collected over an 11-month An EMD should listen for the presence most scrutinized in the Medical Pri- of signs and/or symptoms that could ority Dispatch System™ (MPDS®). indicate higher levels of response The study from 2008 relied on compared to response based on a data gathered between September single answer. 2005 and August 2006 from the Finally, research provides the evo- London Ambulance Service (LAS), lution necessary to MPDS relevance in National Health Service Trust, the dispatch community. In this case, U.K., while the most recent study combining KQs could be the next step expanding on previous research behind the logic of ProQA ®. Results relied on data gathered from an could increase an EMD’s ability to Academy-certified Accredited Cen- send the most appropriate response ter of Excellence (ACE); the study for calls involving breathing problems was published in the same magazine and further the optimum use of our in August 2012. limited emergency response systems. Results from the 2008 study Future research will build on these concluded that the interrogation past studies using different sets of data associated with MPDS Protocol 6 did dem- period. Forty-two thousand cases were and a methodology dependent on the study’s onstrate the protocol’s significance in EMD recorded, of which the patients were almost objective. And that’s what I call the joy of selection of the response code for the breath- evenly split between female and male (52% research. We are never exactly sure where ing problem identified, although it did not— were female and 48% were male), and the research will take us and every project gives nor was it an objective—narrow the selection median age was 61. others the opportunity to view the subject by isolating contributing factors, such as age Among the key findings was the signifi- from a new perspective. g or the patient’s coexisting conditions, in pri- cantly higher potential of cardiac arrest in oritizing the response mode. asthmatic (KQ 5) patients with the following Sources While the MPDS provides a rich mix of conditions precipitating the call: the patient 1 Clawson, J., Olola C., Heward A., Patterson B., Scott G. Profile severe outcomes in the higher priority levels was not alert (KQ 1) and, also, having diffi- of Emergency Medical Dispatch Calls for Breathing Prob- lems within the Medical Priority Dispatch System Protocol. based on reported signs and/or symptoms, the culty speaking between breaths (DSBB) (KQ Prehosp Disaster Med. 2008 Sep-Oct;23(5):412-9. http://www. authors recommended further research that 2); the patient was not alert (KQ 1), having ncbi.nlm.nih.gov/pubmed/19189610 (accessed Dec. 26, would help in the classification of patient sub- DSBB (KQ 2), and changing color (KQ 3); 2012). groups correlated to the patients’ other medi- and, finally, the patient was not alert (KQ 1), 2 Clawson, J., Barron, T., Scott, G., Siriwardena, A., Pat- cal conditions; the existing conditions could having DSBB (KQ 2), and felt clammy to the terson, B., and Olola C., Medical Priority Dispatch System Breathing Problems Protocol Key Question Combinations be related to the reason for the call to 9-1-1. touch (KQ 4). are Associated with Patient Acuity, Prehosp Disaster Med. In the case of breathing problems, rapid These cases would require the higher pri- 2012 Aug;27(4)375-80. DOI: http://dx.doi.org/10.1017/ subgroup identification could result in an ority response coding. S1049023X1200101X (accessed Dec. 26, 2012).

8 THE JOURNAL | iaedjournal.org g PoliceBeat Be Prepared Active assailant incidents develop quickly

Shawn Messinger

ctive Assailant (Shooter) incidents of situations. Precaution also takes careful communication center. Protocol 136 encour- are one of the most dynamic and and concerted preparation. ages full participation by everyone on the Adifficult situations encountered by Representatives from businesses, schools, side of response. law enforcement officers today. Incidents shopping centers, and other venues accom- I also ask communication centers to such as those that occurred in Jonesboro, modating large numbers of people should work with field responders. Consider roles Ark.; Columbine, Colo.; and Virginia Tech work with local police departments to design and responsibilities collaboratively and con- University, Va.; develop very quickly, when coordinated response to active shooters, and, sider unconventional ways to achieve goals and where we least expect them, and are ideally, practice active shooter scenarios. Try- to defuse the incident while safeguarding over in a matter of minutes. ing to respond without a plan is like putting responders and the public. These factors make a rapid response by a seatbelt on during a car crash. It’s too late. For example, in jurisdictions with limited our first responders essential to saving lives. Preventative plans can and do save lives. field staff on duty, the communication cen- Yet, despite intensive officer training in The following are issues you might want ter can function as the Incident Command practiced response to active shooters, several to consider for the communication center: post until response arrives and organizes the minutes might lapse between a 9-1-1 call and command post on scene. A place at the Inci- officers arriving on scene. Add in the time dent Command post—either the center-based it may take to defuse the situation and the or incident-based post—should be dedicated scope of the tragedy can stretch considerably. to a police dispatcher. During initial response, There is, however, a way to stem the flow the police dispatcher has the job to coordi- of lost time: Protocol 136: Active Assailant nate information vital to deployment: the (Shooter), which was added to the Police Pri- number of units and jurisdictions respond- ority Dispatch System™ (PPDS®) v4.1. During ing, the placement of units arriving on scene, this response time, this sort of emergency a the entry points available to responders, and “no man’s land,” the protocol prepares calltak- suspected location of the shooter(s). ers to give Pre-Arrival Instructions (PAIs) to The police dispatcher’s involvement protect callers against further danger and to gives first responders the opportunity to ask questions that provide the framework focus on information relayed and on-scene for scene safety. Through questioning callers deployment, rather than taking attention at the scene, calltakers can let officers know away from the scene in the effort to multi- what they might expect on arrival to these task communication and active response. As high-risk situations. • Are my telecommunicators familiar with mentioned earlier, the arrangement requires Protocol 136 is tailored to effectively the responses officers require to better training specific of incident command roles bridge the gap between the time of the anticipate what information is needed for communications staff to effectively call and officer arrival. Protocol 136 adds from the scene? cover this duty. an ECHO Determinant to PPDS, modifies This might seem an unconventional police officer response to certain situations, • Are policies in place to cover the scope approach, but how many communication and gives instructions easily relayed to callers. of the incidents including but not limited centers are trying to assume that role with- The International Academies of Emer- to multi-jurisdictional agency notification, out specific training? It’s another seatbelt gency Dispatch® (IAED™) in partnership radio traffic, and the possibility that fam- while the accident is happening scenario. with the National Tactical Officers Associa- ily of staff are involved in the incident? Unfortunately, Protocol 136 won’t remain tion (commonly referred to as NTOA) devel- • What about training for calltakers forced untested for long. There is undoubtedly oped the protocol in association with PPDS to make the mental switch from taking someone somewhere planning the next users from California, Colorado, New York, a cold theft report to the fast pace and event. While we cannot stop the next active Maryland, Florida, North Carolina, Canada, urgency of an active assailant incident? assailant incident from occurring, we can Washington, D.C., and the United Kingdom. help mitigate the severity of the event, and The Active Assailant protocol fills a big Many public service agencies provide our professionally trained telecommunica- gap in response, although it’s not the only public outreach, and have done so for years, tors can make a difference in the lives of our piece that should be in place for these types but rarely does the outreach involve the callers and responders. Are you ready? g

THE JOURNAL | March/April 2013 9 g leadershiplingo The Turnover Factor Equate the cost of losing employees

Ivan K. Whitaker, MBA, EMT-P

Although turnover is usually measured Management should primarily focus on actually cost the agency $16.50 per hour in a human resources (HR) setting, it is turnover types for classification purposes with benefits) advantageous for communications manag- since it is essential to identify the categories • TH: The true number of training hours— ers to understand how to evaluate its impact. in range of the manager’s control. Employee include certification courses, orientation, More importantly, communications manag- loss due to low job satisfaction or low KSAs and on-the-job-training ers should understand the implications in must be of primary concern to leadership. regards to the budget, training, scheduling, Employee loss due to health issues, retire - • AOT: The attributed overtime—A new morale, and meeting the demands of the ment, childcare, or maternity leave is not hire placed on the allocation cannot be organization’s goals. under leadership control; however, these counted on the daily schedule. A trained reasons are numerically predictable and member must cover the shift until the new hire finishes training. Although Reasons should be monitored. overtime is usually budgeted, capturing Studies indicate a national turnover rate There are three factors attributing to an this number gives a detailed account of between 17%–19% in telecommunications. employee’s decision to leave: the perceived overspending in the overtime line item. In other words, two out of every 10 telecom- desirability of leaving, the perceived ease of municators leave the profession each year. A leaving, and the alternatives available to the • I: Incentives paid to the trainer telecommunicator’s career averages two to employee. As the desires of an employee • CC: Certification costs three years. change, so does the employee/organiza - Reasons for high turnover include: low tion relationship. Members may perceive Equation knowledge, skills, and abilities (KSAs) of the current work-based compensation and (NHHR x TH) + (AOT + I + CC) applicants leading to costly errors and termi- rewards inadequate. This is especially the case (New hire hourly rate x training hours) + (attrib- nations; the “adjustment factor” or inability when organizations increase the workload uted overtime + incentives + certification costs) to conform to the demands of the profession; of employees without compensation. The New hire hourly rate: $16.50 Training hours: 504 disciplinary issues; stress; low pay; scheduling absence of flexible work schedules and limited Attributed OT: $9,072 conflicts and rotating shifts; workload; lack perks may also cause employee dissatisfaction. Incentives: $0 Certification costs: $1,000 of leadership; inefficient training programs; ($16.50 x 504) + ($9,072 + 0 + $1,000) and limited promotional opportunity. Budget impact $8,316 + $10,072 Regardless of the reasons, the impact of Budgeting is usually a part of a manager’s Total = $18,388/new hire turnover must be evaluated. responsibilities. Line items might include There are several ways to calculate turnover. capital, supplies, training, personnel costs, Equation breakdown For simplicity we will use the W-2 Method. overtime, maintenance, facilities, and cer- Seventeen employees would equate to • Identify the number of W-2s issued in a tifications. Several line items are directly $312,596. This is an astronomical number. particular year impacted by turnover. Of course, overtime Do you ever wonder why you are always is easily recognizable. How about training? overspent in the overtime line item? In the • For that same year, determine the final What is the amount your center actually next column, we will look at controlling number of employees on Dec. 31 spends on training each year (the bottom turnover as part of the HR process and • Divide the number of W-2s issued by the line)? In evaluating a more inclusive cost fac- ways to increase employee retention. g number of employees remaining on Dec. tor, how much is your center spending per 31 of the year evaluated new hire? Sources 1. Alderman, J. (2011, Sept.) Turnover rate in line with national • Subtract 1 average says acting chief of emergency services. Cumberland The math Times-News • Multiply by 100 To determine the training cost per 2. Carlson, B. (2012, Oct.) America’s butts are plaguing Say you have 60 employees at the end of employee (TCPE) you will need: emergency responders with mistaken calls. The Daily 2010; however, 70 W-2s were issued. Divide: • NHHR: The hourly rate of the new hires— 3. Headsets911: Common stressors for dispatchers. Retrieved 70/60 is equal to 1.17. Subtract 1 and you this is not the base hourly rate; include Jan. 21, 2013 from http://www.headsets911.com/common- have 0.17. Multiply 0.17 by 100 and 17% is benefits in the hourly rate for accuracy stressors.htm your turnover rate. Ultimately, this means (An employee making $12 per hour may 4. March, J. G., & Simon, H. A. 1958. Organizations. New York: out of 70 employees, 10 were lost in 2010. John Wiley

10 THE JOURNAL | iaedjournal.org IndustryInsider Cellular providers able. In addition to meeting the needs of agree to “best effort” wireless subscribers, the text-to-9-1-1 service text-to-9-1-1 services accommodates the emergency communication needs of the deaf, hard of hearing, and Four of the nation’s largest cellular pro- speech-impaired. The “best effort” services viders have voluntarily agreed to provide commitment alludes to the technologi - “best effort” text-to-9-1-1 emergency com- cal shortcomings of SMS, which is a store- munication services no later than May 2014. and-forward messaging technology never According to the agreement, the service designed to provide time-sensitive service. will allow SMS messaging to public safety The voluntary agreement includes the answering points (PSAPs) to meet “near following provisions: text-to-9-1-1 service will term objectives” of providing text-based be implemented within a reasonable time, emergency communications until a com- within six months, of a PSAP’s request and the prehensive national NG9-1-1 service is avail- four cellular providers will submit quarterly

recognition National groups honor Dr. Clawson for contributions to EMS

Jeff Clawson, M.D., was recently pre - their continued development, especially the Association (AAA). He is only the second sented awards from two national organiza- initial training and certification of profes- individual in the award’s history who does tions in recognition of his contributions to sionals, represents a major contribution to not direct an ambulance service to be so Emergency Medical Services (EMS). EMS and has saved countless lives.” honored. The award recognizes excellence in Dr. Clawson said he felt very honored by leadership and dedication to the betterment the awards. of EMS nationwide. “There’s no greater tribute than the The AAA resolution accompanying respect of your peers for work that has been the award praised Dr. Clawson for having both personal and rewarding,” he said. “It says “revolutionized the way that EMS calls we believe in what you do. Your contribu - are processed and created and the first tions have helped people in need.” evidence-based system related to the field The Dr. Ronald D. Stewart Award from of EMS (dispatch protocols).” He is also the National Association of EMS Physicians noted for working “tirelessly to promote (NAEMSP®) honors an individual or a group high standards in training, education, and making a lasting, major contribution to the a universal emergency protocol, making a EMS community nationally. difference to countless citizens and emer- IAED™ Academics & Standards Associ- gency responders alike.” ate Brett Patterson nominated Dr. Claw - Past AAA President J. Walter Schaefer son based on his tenacity and dedication (1979-1981) founded the first air ambulance to EMS through the development of the service in the U.S. in 1947. 9-1-1 Medical Dispatch Protocols now used Dr. Clawson was honored during the The IAED is an international organiza- in 2,861 emergency dispatch centers in 43 awards luncheon held on the final day of the tion headquartered in Salt Lake City created countries, including the United States, three-day annual NAEMSP conference held in 1988 as a standard-setting organization Canada, United Kingdom, Australia, Aus- mid-January in Florida. for the field of emergency medical dispatch. tria, Germany, and Brazil. “It was so great to see him amongst his IAED has occupied two roles: one as a mem- “The EMD is the principle link between fans and he has a lot of them at NAEMSP,” bership-driven association for the professional the public and the caller requesting emer- said NAEMSP Executive Director Jerrie recognition of dispatchers and, the other, as gency medical assistance and provides a Lynn Kind. an Academy that develops and maintains fundamental role in the first responder, Dr. Clawson was also presented the fire, police, and medical dispatch protocols ambulance and paramedic delivery system,” J. Walter Schaefer Memorial Award of and training curriculum for member use in Patterson said. “Dr. Clawson’s dedication to Excellence from the American Ambulance response to emergency calls for help. g

THE JOURNAL | March/April 2013 11 progress reports, beginning July 13, 2013, sum- FCC Chairman Julius Genachowski told emergency,” said department Lt. Slade Schultz. marizing the status of national text-to-9-1-1 The Journal in a recent interview that call “It’s a rural area and it was really frustrating for capability. PSAPs will be responsible for asso- centers have been working diligently with responders trying to find the house.” ciated costs of delivering text messages (e.g., his and other federal agencies to move into Rather than demanding that residents fig- additional trunk groups), and the cellular pro- the digital age. ure out what to do, the fire department came viders will implement an auto-reply message “Meanwhile, the public they serve is buy- up with a plan that reinforces Greenfield’s to alert subscribers to dial 9-1-1 when attempt- ing up apps and devices as soon as they come “every second counts” campaign. Residents ing to text 9-1-1 in areas where the text-to-9-1-1 to market,” Genachowski said. “That in turn can simply stop by the fire department to option is not offered. has led to the public just assuming their 9-1-1 purchase green reflective letter address signs The Federal Communications Com - center is as sophisticated as they are.” for posting on their mailboxes. mission (FCC) also issued a proposal to require the service to make “significant Going green deployments” in 2013 to “keep pace with accommodates response how consumers communicate today and environment can provide a lifesaving alternative in situations where a person with a hearing or Greenfield Township Fire Department in speech disability is unable to make a voice Carroll, Ohio, added a dimension to going green call,” according to an FCC press release even before the euphemism became popular dated Dec. 12, 2012. At the same time, the for defining environmentally-friendly practices. commission emphasized that text-to-911 Fifteen years ago, the rural town - “will be a complement to and not a substi - ship—5,000 residents in 29 square miles—real- tute for existing voice-based 911 service, ized technology wasn’t the only answer to its and that consumers should always make 9-1-1 issues. In fact, there was one big prob- a voice call to 911 during an emergency if lem that had to be solved before anything they can.” Commissioners also proposed else worked right and, yes, it was related to action to “accelerate the nation’s transition the environment. to NG911 to assist first responders in keep- “People weren’t making their addresses vis- ing communities safe.” ible enough for personnel to find them in an recently elected NG9-1-1 Institute elects Denise Amber Lee Foundation VP to board emphasize the importance of a well trained if in place in 2008, could have averted the and technologically advanced 9-1-1 system tragedy in their family. than to highlight the tragedies that can hap- A major milestone was Florida’s state- pen with a less than perfect system,” he said. mandated standardized training for telecom- Denise Amber Lee was abducted from municators that went into effect Oct. 1, 2012. her home on Jan. 17, 2008, and despite According to the law, all public safety tele- numerous calls to 9-1-1, including one from communicators must be state certified, and a person witnessing the crime in progress, they are required to accumulate continuing she was murdered by her captor; her body education hours leading to recertification was discovered several days later buried in every two years. The Florida Department of a shallow grave not far from the Lee family Education established a 232-hour curriculum home in North Port, Fla. The death of the for new hires. 21-year-old mother of two boys was ulti - The Next Generation 9-1-1 Institute was Mark Lee, vice president, Denise Amber mately blamed on the communication cen- established in 2003 to assist the NextGen Lee Foundation, is among five new members ter receiving the 9-1-1 calls and its failure to 9-1-1 Caucus in advancing emergency com- recently elected to the Next Generation 9-1-1 dispatch response. munications. The 2,000-member institute Institute Board of Directors. In response to the tragic death, the elects board members from public safety, Lee, who was elected to represent the foundation has worked diligently over industry, and other non-profit agencies to member at large position, said mandatory, the past several years to improve the 9-1-1 provide guidance and recommendations. uniform training is a foundation priority system. Founders Mark and Nathan Lee, Lee said he would also like the institute’s that meets the institute’s objective to raise Denise’s father-in-law and spouse, respec- “Hometown Security” events conducted on awareness of issues in 9-1-1. tively, have traveled extensively in their a regular basis to raise public awareness and “What better way to raise awareness and campaign to push minimal standards that, bring publicity to the issues in each state. g

12 THE JOURNAL | iaedjournal.org The signs are sold at the $8 cost to the “That doesn’t happen very often when a ing the National Fire Protection Association department, and all residents have to do is bike is stolen.” (NFPA) standard for emergency services stop by with the exact amount for purchase. communications (NFPA 1221). If the house or business happens to be near a Pipeline emergency According to the NFPA release, the dry hydrant, the fire department provides a response just got faster NFPA revised the total dispatch transac - blue sign instead to set them apart. tion time to within 90 seconds at 90% of “The signs have helped,” Lt. Schultz said. The “immediately and directly” part of the time and within 120 seconds at 99%. “We’ve been selling them as long as I can a recent Pipeline and Hazardous Materials The revision affects six categories of calls remember and I haven’t heard any complaints.” (as listed in Section 7.4.2.2), including calls requiring EMD questioning and pre-arrival Right time, right medical instructions. place, and right call The former blanket for transaction time was 60-second dispatch 90% of the time The crime-solving stars must have been (Note: Before that, the standard had been aligned exactly right for EMD Danielle Shor- (within) 60 seconds 95% of the time). Total rock in early December 2012. The dispatcher dispatch transaction time takes into account for the Fenton Police Department (Mo.) was receipt/pick-up of initial 9-1-1 call, caller driving home from work when she noticed an interrogation, determinant prioritization/ Oakland County Sheriff’s deputy placing into selection, and tone out of resources. his patrol car a red, chopper-style bicycle with The revision went into effect in 2013 and a distinctive red flame pattern on the seat. remains in effect for at least three years, until “The bike looked exactly like the one the next edition in 2016. reported stolen earlier in the day,” said Shor- Greg Scott, operations/research analyst rock, who had heard about the non-emer - for the International Academies of Emer- gency call from a Fenton woman describing Safety Administration (PHMSA) ruling put gency Dispatch® (IAED™), said the Academy her son’s bike that went missing from their the National Emergency Number Associa- favors extended time windows, although— yard earlier that day. tion (NENA—The 9-1-1 Association) quick at the same time—the Academy has never to the call. endorsed a single national standard for call A PHMSA ruling effective Oct. 11, 2012, processing times. requires pipeline companies to “immediately “The reality is that there is no vali - and directly” contact the nearest 9-1-1 center dated research to support a 60-second in the event of an actual or potential emergency. Prior to that date, a pipeline operator might have reached a 9-1-1 center thousands of miles away when the call landed at the center closest to the source of the call as opposed to the source of the emergency. NENA jumped to the rescue, launching a database designed to put pipeline operators in direct contact with the 9-1-1 center Shorrock stopped, told the deputy her closest to the source. The PSAP Information suspicions, and, in return, she was told that for Pipeline Emergencies, or PIPE for short, the bike he was loading into his police car database provides direct, inbound, 10-digit had been used in a breaking and entering. numbers to be used for specific 9-1-1 centers. Since the bike was considered part of the The database is available crime, it was now police property. on an annual subscription A few phone calls later and the investi- that includes the initial setup gation was complete. The Oakland County and three free updates per More information Sheriff’s Department contacted Fenton police year. Subscriptions rates vary can be found dispatch standard, particularly one that to confirm it was the bike reported stolen. It according to the number of at www. requires 90% compliance to all calls, was. The person arrested for the breaking and jurisdictions being served. nenapipedb.com regardless of their nature,” he said. “We entering was identified—despite a false name are often asked about national standards he had given at the time of the arrest—and the National fire protection for total dispatch transaction time, but is county is prosecuting him from both breaking regulations stipulate 9-1-1 it really reasonable to expect the dispatch and entering and the stolen bike. response times time standard on a sprained ankle be the Shorrock said the best part of the story same as for a sudden arrest?” goes back to the start. There’s good news for emergency medi- Pragmatically speaking, Scott said, the “The owner got his bike back,” she said. cal dispatchers (EMDs) from agencies adopt- one-size-fits-all approach doesn’t work for

THE JOURNAL | March/April 2013 13 several reasons. For one thing, existing com- • Calls requiring language translation Name your road puter-aided dispatch (CAD) technology is • Calls requiring the use of a TTY/TDD not standardized enough across emergency device or audio/video relay service call center boundaries to accurately com - • Calls of criminal activity that require pare times from agency to agency. Beyond information vital to emergency responder that, he said, there may be design and con - safety prior to dispatching units trol weaknesses that significantly affect con- clusions based on data. • Hazardous materials incidents “Call processing standards should reflect • Technical rescue the nature of the call,” he said. “That is, DEL- TAs and ECHOs should have one target The NFPA uses the term alarm process- time window, while the remainder should ing instead of call processing as a throwback have another longer time window. Only a to the era of fire alarm boxes. The NFPA small percentage of 9-1-1 calls are true emer- promotes telecommunicator certification gencies where shaving seconds from the call and quality assurance/improvement to processing clock could have any impact at “ensure the consistency and effectiveness all on the case outcome.” of alarm processing.” If you’ve ever had a hankering to name In general, he said, a 90- (to 100-) second your road or lane—and you happen to live in time frame is a reasonable target for com - West Virginia EMD Marshall County, W.Va.—here’s your chance. pleting DELTA and ECHO cases, although mandate goes into As part of Marshall County’s conversion to 90 or 95% fractal compliance to such a target effect July 2013 E9-1-1 addressing, county residents currently is difficult to meet given issues with address living on unnamed roads or lanes are being verification from wireless phones. asked to suggest a name for their road. “The problem with any dispatch time Since each name can only be used once, standard is that it takes the focus away from the county E9-1-1 site provides a list of names the most important elements of emergency no longer available (already taken). The list is dispatching—safety and accuracy,” Scott said. long, dating to March 2003, and includes the “Anyone can complete a process fast if you following unique names featuring a mixture make lots of errors. But errors are the last of local family names, geographical markers, thing we need more of in a 9-1-1 center.” wishful thinking, and fun: Almost Heaven Jay Dornseif, Priority Dispatch Corp. ™ Lane, Black Sheep Lane, Buzzard Road, Deedle fire consultant, agreed that the extended Drive, Grannies Lookout Loop, Hog House time window was a necessary revision in Road, Lala Lane, Mozart Meadows, Never NFPA standards, but he also cautioned Seen Lane, Ram Drive, Redneck Drive, Sallys against the urge to meet a time standard sim- Backbone Road, and Sputnick Run Lane. ply to make the center’s statistics look good The state of West Virginia has man - to outside observers. dated that by July 2013 all 9-1-1 centers Downtime from outages “That’s when mistakes are made,” he said. must have an emergency medical dispatch affects PSAPs of all sizes “It is more important to do it right the first process in full swing and have the money time than do it a few seconds faster and get to bear the costs of training and hiring any Outages in public safety answering it wrong. Fortunately, calltakers who follow extra staff required. points (PSAPs) resulted in downtime during a protocol consistently gather more informa- According to the legislation, the director a 12-month period at 72% of PSAPs serving tion in the same time frame or faster than of each county emergency dispatch center those who try to make up questions and must develop policies and procedures to instructions on the fly.” establish a protocol for dispatching emer- Other revisions in the standard include gency medical calls using a nationally recog- a change to 80% (from 90%) of emergency nized emergency medical dispatch program alarm processing must be completed within or an emergency medical dispatch program 60 seconds, and 95% of alarm processing approved by the Office of Emergency Medi- must be completed within 106 seconds. The cal Services. Gov. Earl Ray Tomblin signed exceptions—calls that must be completed the legislation in March 2011 after legislators within 90 seconds 90% of the time and approved the bill with little debate. within 120 seconds 99% of the time include According to statistics at the time the (as listed in 7.4.2.2): legislation was approved, about 40% (21 populations of more than 80,000 citizens, • Calls requiring emergency medical dis- counties) of 9-1-1 centers in West Virginia according to an October 2012 survey of 390 patch questioning and pre-arrival medical provided EMD, 40% (20 counties) were plan- PSAPs conducted by Stratus Technologies. instructions ning to provide EMD, and 20% (7 counties) Survey results also showed that 50% experi- had no plans to provide EMD. enced 2–4 outages and 11% had more than

14 THE JOURNAL | iaedjournal.org five. PSAPs in communities of less than Ground Mobile Radio Device by the Center 80,000 fared somewhat better, with six out for Public Integrity and radio communica- of 10 suffering downtime at least once in the tion device experts, the problem whether past year. in war, or hurricanes, or emergencies such as Survey respondents identified them- fires or large motor vehicle accidents or mass selves according to job responsibility, size of shootings is the old problem of normally population served, and geographic entity— independent frequencies being able to talk town/city, county, metro, multi-county, and to each other in a crisis; it’s still the problem state; town/city and county accounted for and will be for some time. 83% of respondents. Despite the capacity and variety of emer- In addition to the number of incidents, gency communications, dissonance and static respondents reported on the duration of Communication breakdown caused numerous calls for help to be lost, downtime per incident. Fifty-seven percent remaining a similar obstacle but on a smaller of outages lasted at least 15 minutes and Front and center of the after-action scale that many agencies are overcoming 26% stretched beyond an hour. One hour reviews following Hurricane Sandy this past with more advanced mobile command cen- of downtime could potentially affect six October was the less-than-hoped for perfor- ter communication hubs that make it pos- 9-1-1 calls at a PSAP handling 50,000 calls mance of communication equipment. The sible for normally independent frequencies annually, or 29 calls at an annual volume of multiple after-action reports—based on tests to “talk” to each other. Even those advances 250,000. The number of calls affected could by U.S. troops in Iraq—are showing another remain mostly on emergency services agen- be higher or lower at various times of day. kind of emergency communication hitch— cies’ wish lists, given budget cuts still being In answer to questions relating to pre - including the one-radio-fits-all Joint Tactical imposed by a sluggish revenue stream due to paredness for natural disasters or cata - Radio System—remains a problem with a the still-faltering U.S. economy. strophic outages, 29% said they had no thousand theories but so far no single solution. Difficulties in communications were the formal disaster recovery/contingency plan Research and development will continue dominant discussion points in after-action or, just as disconcerting, did not know if a after a fashion, but the hope of having an all- meetings regarding the response to Hur - plan existed. Another 25% said they did not in-one master Ground Mobile Radio device, ricane Sandy, with service providers saying have or were uncertain about a back-up loca- with local PSAP applications eventually avail- they were able to get by with trading radios 7.5 in. tion for restarting dispatch operations in the able, won’t be part of it. with other responders or resorting to per - event of a primary-site failure. According to an ongoing reckoning of the sonal cell phones. g

Helping you save time — and lives — since 1996. 4.875 in.

For more than 16 years, we’ve supported you. And we’ll continue to work alongside you, quickly guiding you to the scene and connecting you to our subscribers. In these days of shrinking resources, you can feel confident knowing the advanced technology of OnStar® is always on duty.

13OTM019_C__164544A01.indd 1 2/2/13 2:44 AM

13OTM019_C 0.0 0.0 13OTM0014 MC 2013 OnStar Public Safety Navigator 7.5 4.875 124041 New 02/01/13 0.0 0.0 02/01/13 17:02 PM 4C Magazine Internal 1/0 1 of 1

N/A A. Matzenbach B. Paynter J. Bratton D. Bush T. Novik 6269

KC 3 164544A01 1st_Assembly 02/02/13 recognition Award recognizes excellence in dispatch compliance

calls a year that result in the transportation of about 38,000 patients.

It’s a first for FPDS in the Netherlands

Success using the Medical Priority Dis- patch System™ (MPDS®) convinced the Safety Region Noord-Holland Noord in the city of Alkmaar to become a dual pro - tocol user through the implementation of the Fire Priority Dispatch System™ (FPDS®). Director Jos Stierhout said it was the natural step to take. “The Fire Protocol was a logical step in the constant quality improvement of the center,” he said. The consolidated center answers calls involving fire, medical, and police response. All EMD calltakers are registered nurses Dedication Shows From left to right: Allen McKay (Associate Director), Elfriede Lane (Commander), Michael Sanderson (Deputy Chief), Matt Rate, Shane Elliot, Rick Morency, Kelly Newell, John Cunnane (Chief), Kevin Smith (Deputy Chief), Dayman Perry (Com- and, also, trained as fire calltakers and dis - mander). Absent: Julie Noble patchers. EFD certification is next in line, After seven years of dedicated and deter- at least 48 randomly selected calls audited by and will precede the goal to go live with mined call processing, Shane Elliot finally the in-house ED-Qs™. the Fire Protocol in fall 2013. The center made it to the front of the line. This is Elliot’s sixth year making it to received 8,368 fire-related calls in 2012. Not that the No. 1 spot was the EMD’s the top five, but his first year at the No. Alkmaar is a city in the province of sole objective at the Niagara Emergency 1 spot. Matt Rate, who took top place in Noord Holland in the Netherlands and Medical Services communications center in 2010, came in second, followed by Rick is home to one of the country’s 25 safety Ontario, Canada, but the ability to take first Morency (first in 2011), Kelly Newell, and regions. North Holland has a population place surely has its benefits. Julie Noble. The leading EMD receives a of 2.6 million people and covers approxi - “It’s bragging rights,” said Dayman Perry, trophy and a gold pin, while the four oth - mately 2,671 km 2 (approximately 1,660 operations commander. “Although there’s ers receive a bronze pin. They also receive square miles) including both urban and a lot of good-natured ribbing about who letters of commendation and certificates. rural communities. Medical emergency calls gets the award, this is something they take Three additional EMDs scoring greater are immediately transferred to the regional very seriously.” than 99%, but slightly below the winning EMS dispatch center. The European emer- The “seriously” is more about their job, scores, received honorable mentions. gency number 112 is the only emergency than the award, although the two are cer - Perry said the award isn’t just about number in the Netherlands. g tainly related. individual achievement, The center has used the Medical Prior - but it does further moti- ity Dispatch System ™ (MPDS®) Protocol vate his already “highly since beginning operations seven years ago dedicated” staff and and is looking to its third medical ACE reinforces the center’s recertification. The center was initially ongoing commitment of certified in 2006. excellence to the public. The 25 full-time and 5 part-time systems “One hope is to set the status controllers have never been without example and for some, it is their EMD certifications, and each year for a goal,” he said. “But they’re the past seven, they have competed for the all hard working. They’re honor to be among the top five EMDs chosen all dedicated to giving for the annual Priority Dispatch Award for excellent service.” Excellence in Compliance. The award recog- The Niagara EMS nizes high compliance—scores greater than communications center Logical Step Forward Safety Region Noord-Holland Noord Director Jos Stierhout said 99%—and figures in the individual results of receives more than 70,000 FPDS was a natural in the country’s progression of quality dispatch.

16 THE JOURNAL | iaedjournal.org g NAVIGATOR REWIND g 9-1-1 Education g ace achievers g fAQ g NAVIGATOR BestPractices g NAVIGATORREWIND Attitude Is Everything Sunstar goes the distance for employee satisfaction

Turnover isn’t a major issue. “A lot of our employees are long term,” said Eric Fayad, a CTO at the center located on the west coast of Florida. “We bend over backward, almost to a fault.” Shiner and Fayad shared the podium at NAVIGATOR 2012, discussing the strides the communication center has taken in the past decade to train candidates and keep them employed. Their 50-minute talk and 17-slide PowerPoint presentation, “When They Just Don’t Get It,” highlighted red flags raised in the hiring and training processes and solutions to warning signals that effectively—and quite hopefully—“nip the problem in the bud,” according to Fayad, also a Sunstar paramedic since 2001. “It’s not always possible,” he said. “But we certainly try.” Red flags in the training phase are the stuff familiar to centers: trouble multi-tasking, a less than nice personality, poor work ethic, or loss of dedication. a positive environment (which, in turn, trans- They try to catch the flags during the By Audrey Fraizer lates into satisfied customers). hiring process, which includes a 30-minute “Attitude is a choice I make when I come more personable chat to pick up on quirks When Tinker Bell or Sleeping Beauty age through the door,” Shiner said. “It’s a choice not noticeable in a general interview, and out of Disneyland, they will still be welcome employees make at work. We hang our hats that’s despite an already fairly well vetted at a place that’s not much of an amusement on attitude every day.” profile of the person. Most of the center’s park although every bit as people conscious. An off-track, off-game employee might candidates—close to 100%—are Sunstar para- But, the same wouldn’t apply to Captain be guest to pep talks Disney World style, medics with at least two years working expe- Hook or Maleficent. cool down and de-stress via walks through rience in Pinellas County. “Attitude is 100% with us,” said Ron the neighboring botanical garden, or a sit- “We rarely hire from outside,” said Shiner, Shiner, communications training coordi- down with a CTO at a local restaurant to also a Sunstar paramedic. “But if someone nator (CTC), Sunstar Paramedics/Pinellas discuss the problem. you thought would be great doesn’t turn out County Emergency Medical Services, Fla. Employees going above board can earn that way, there’s a good chance that person “We will go to great lengths for someone points to “spend” on gift certificates and can return to the field.” with a great attitude.” time off, while Sunstar Paramedics, which A candidate making it past the hiring Shiner wasn’t kidding about the “tremen- holds the license for paramedic ambulance phase moves to 64 hours of seat time that dous lengths” the agency goes; he wasn’t exag- services in the county, invites all of its involves lecture and hands-on practice in the gerating the focus on attitude. Granted, this employees—no matter performance or atti- center’s dedicated training room equipped is no Magic Kingdom, but the Sunstar com- tude—to barbecues, discounted eats, and with the technology of their future, such as munication center makes it a point to create free tickets to sporting events. CAD-installed ProQA® (although the off-line

THE JOURNAL | March/April 2013 17 training dongle version) and a geographical information g 9-1-1Education system. Graduation from the classroom requires passing an eight-section test; a candidate failing one section can retest in six months, while a candidate failing two or Let’s Celebrate! more sections must wait one full year. Once a candidate goes out on the floor, a mini - National 9-1-1 Education Month mum of 14 shifts (one full month) are spent learning radio, followed by 14 shifts devoted to EMD training promotes awareness and certification. Candidates must achieve 95% compliance, although the center’s 98% compliance standard must be reached in the months following completion of the training program. The center uses a three-tier training program: preceptors, CTOs (who are also the center’s QAs), and the CTC (Shiner), meaning candidates are never left out in the cold. Supervisors are never part of the training team. Preceptors are the “bread and butter,” Shiner said. The one-on-one teachers are responsible for writing up daily evaluations, signing off on task competency lists, and asking the CTOs for advice when it comes to modifying the training program to suit the “just don’t get it” candidate. Preceptors are required to pass the center’s adult learning education program that Shiner admits borrows from Disney’s customer service training. “Be nice,” Fayad said. “We want to treat every caller, every responder with kindness.” ber on behalf of Comcast. When attitude and work ethic go south for an By Jenifer Goodwin The National 9-1-1 Education employee during any stage of employment, Shiner Coalition was created to leverage the and Fayad suggest the high road. Immediate termi - resources of membership organiza- nation is rare. Management tries to get to the root The rapid pace of communica - tions serving the 9-1-1 community, of the problem, understanding what experience has tions-related technological changes including the NG9-1-1 Institute taught them. has made teaching people what 9-1-1 and the International Academies of “Most times there’s more than what you’re see - can—and can’t—do both more urgent Emergency Dispatch®. Aside from the ing,” Fayad said. “It could be that the person is going and more complicated. expertise it represents, the Coalition through a divorce, can’t make the mortgage payment, “Telephony has changed dra - also provides educational and public or doesn’t get along with the supervisor. We’ve taken matically over the years with wire - relations materials, including ban- people off headquarters. We try to make it more com- less phones, texting, and Voice over ners, fliers, and posters, free of charge fortable for the person to say what’s happening.” IP,” said Alisa Simmons, manager of to the nation’s PSAPs. The communication center has EMD and radio public marketing for the Tarrant With 80% of calls to 9-1-1 com - honor boards listing that month’s high compliance County (Texas) 9-1-1 District. “It’s ing from cell phones, Campaign 2013 achievers. Honorees receive points that in combination very important that citizens under- focuses on teaching the public to “be with points earned for “pats on the back” can be cashed stand the differences between land- 9-1-1-ready” and give clear, precise in for gift certificates and time off. lines and other devices when they location information, Arocho said. Larger company-sponsored events address the try to reach 9-1-1 for help.” “Even if you’re a small PSAP operat- entire Sunstar community: managers and directors April 2013 marks the sixth annual ing on a small budget, there are simple cooking hamburgers at the second Thursday of every National 9-1-1 Education Month, and things you can do to promote public month barbecues, once a month dining out excur - a busy time for Simmons who spear- education.” sions to local ethnic restaurants featuring employee heads the district’s 9-1-1 public educa- Here is how three programs cel - discounts, and tickets to Tampa Bay Rays games. tion efforts to reach nearly 2 million ebrate the month. Of course, there is only so far you can go with any people in Fort Worth. trainee or long-term employee, Shiner said. The National 9-1-1 Education Tarrant County, Texas “That’s something you have to decide,” he said. “At Coalition took inspiration from the A 2011 survey of 1,000 residents some point, you might have to admit it’s not working.” efforts like that of Tarrant County. in Dallas-Fort Worth commissioned Shiner oversees the training and standard of care “There’s power in speaking with by the Tarrant County 9-1-1 District for the communication center’s 35 paramedic EMDs. one voice when it comes to public found that 62% believed calltak - Fayad was the Pinellas County EMD of the year in education and the critical role of the ers could pinpoint their location if 2012. The center receives about 225,000 9-1-1 calls a public safety telecommunicator,” calling from a landline in a hotel or year, of which more than half require transport, and said Angel Arocho, NG9-1-1 Institute office building. Nearly 38% believed it is an Academy Accredited Center of Excellence. g Board chairman and a Coalition mem- that calltakers would know the

18 THE JOURNAL | iaedjournal.org Honor your dispatchers during Public Safety Telecommunicators Week

While getting the word out about son saved is willing to participate 9-1-1 to the public is important, so is in interviews. showing appreciation for those on the Create a dispatcher of the year address if the call to 9-1-1 was from a cell phone, while other end of the line—the calltakers, dis- award and host an annual dinner to 17% were unsure. patchers, and other public safety tele- announce the winner and, also, honor The survey also found significant misinformation communications professionals who are all of your calltakers. about texting 9-1-1. Nearly one-third (31%) of respon - the “first, first responders.” dents thought they could text 9-1-1, while 35% said they And the perfect opportunity each About the National 9-1-1 Education were unsure. Only 34% correctly answered that 9-1-1 year is during the third week of April Coalition couldn’t accept texts. in celebration of Public Safety Tele- In October 2010, a volunteer To correct such misperceptions, 9-1-1 education is a communicators Week when PSAP group of public safety, education, year-round effort there, said Simmons, with activities that administrators; public safety colleagues and industry stakeholders formed include school assemblies, safety fairs, and other commu- in police, fire, and EMS; and the general the National 9-1-1 Education Coali- nity events. Special events for April include her favorite, public are urged to thank 9-1-1 profes- tion to support the nationwide coor- an annual “Heroes Conference,” which recognizes mem- sionals for their contributions to the dinated promotion of National 9-1-1 bers of the public, usually children, who have made a health and safety of their communities. Education Month and National Pub- heroic call to 9-1-1. Here are a few ideas for how you lic Safety Telecom- To gather their stories, Simmons starts asking 9-1-1 can celebrate in your community. municators Week. center managers for referrals about six months before 1. Host a PSAP open house and give The Coalition’s 9-1- the event. She reviews the audiotapes looking for 1: The Number to the community a closer look at the To download 9-1-1: certain criteria, such as a child dialing 9-1-1 without public safety system and the people Know awareness The Number to the help of an adult. She doesn’t touch calls involv - on the receiving end of the 9-1-1 campaign promotes Know resources, go ing domestic violence cases and looks for stories with public awareness to www.know911. call. Be sure to invite your elected org happy endings, such as the five-year-old girl who dialed officials, the media, and your pub- and the effective use 9-1-1 to report that her grandmother had a seizure lic safety colleagues of 9-1-1 resources. while cooking dinner. The dispatcher even helped the in EMS, fire, and law The Coalition also supports access little girl safety turn off the stove. enforcement. to the “best of the best” 9-1-1 edu - “In all these calls, you can hear the emotion of the cational and promotional ideas and kid,” Simmons said. “They are a little upset, a little pan- Recognize pub- promotes the advancement of 9-1-1 icked, but they are in control because the calltaker has The National 9-1-1 lic safety telecom- technology and services to foster pub- Education Coalition them in control.” toolkit provides an municators with a lic access to emergency help. Children recognized as 9-1-1 Heroes receive a plaque, a example at www. proclamation by a Coalition members include: know911.org medal, and a backpack with goodies such as movie tickets, prominent local or • NG9-1-1 Institute gift cards, 9-1-1 umbrellas, a jacket, and a coloring book. state official. • 9-1-1 for Kids® Simmons also provides individual PSAPs with bro- 2. Celebrate with food! At the Salt chures, pens, and other 9-1-1 educational giveaways to Lake Valley Emergency Commu- • Association of Public Safety Com- hand out at community events and school presentations. nications Center (VECC) near munications Officials (APCO) “I will go out to events with them the first few Salt Lake City, Executive Director • Industry Council for Emergency times,” she said. “Once they get going, they handle it on William Harry enlists the help of Response Technologies (iCERT) their own.” police, firefighters, EMTs, and para- • International Academies of Emer- medics to order pizzas, arrange a gency Dispatch® (IAED™) King County, Washington potluck, or cater a lunch for each Power outages from winter storms in Seattle turned shift. Other centers might provide • National Association of State 9-1-1 into a problem-solver for the King County E-911 Pro - desserts, have a cookout, or pull Administrators (NASNA) gram Office, which administers 12 PSAPs making up the together gift bags filled with snacks • National Emergency Number regional emergency 9-1-1 system. Knowing the frustration and movie passes donated by local Association (NENA) that comes with repeating the same information over and vendors. over again in relation to recurring non-emergency calls, For more information about the the office created the website “Links by Zip” and taught 3. Recognize a staff member who Coalition, visit www.ng911institute. the public how to use it. helped save a life with dispatcher- org or contact Carla A. Anderson, By simply accessing the site and supplying a zip code, assisted CPR. Share the story with deputy executive director, at carla@ the resident can retrieve the correct phone numbers for the media, particularly if the per- ng911institute.org. g

THE JOURNAL | March/April 2013 19 ber of accidental calls from cell phones has billboards, a smartphone app for accessing since dropped 19% (from 30% to 11%). non-emergency numbers, televised public Their most recent program—”Smart911”— service announcements, and radio spots in established a secure PSAP integrated data- Spanish and English. Check out the TV ads base of voluntarily registered cell phone at http://911.utah.gov numbers correlated with personal profiles, “The 9-1-1 system isn’t just the technical such as work and home addresses, languages part—the equipment and network,” said Wil- spoken, and information about medical con- liam Harry, executive director of the Salt Lake ditions or disabilities. Valley Emergency Communications Center “What we really like about Smart911 is the (VECC), and a member of the state commit- ability to associate an address with a cell phone,” tee. “The most important element is the person Lum said. “I live in a 105-unit condo complex. who has to use the system. People don’t use I don’t have a home phone. If I’m not able to 9-1-1 on a routine basis and usually they are speak, and I call 9-1-1, dispatchers can see what distraught. They need to know how to use the city service inquiries. Since the site was devel- complex I’m in, but not what unit I’m in. With system to make it easier and more efficient for oped in 2009, it has averaged about 40,000 Smart911, they will know to try my unit first.” them for when they do have that emergency.”g visits annually. So far, they’ve collected more than 4,500 “Just telling people don’t call 9-1-1 for this profiles from 2,200 households, Lum said. or that doesn’t work,” said Kayreen Lum, the public education coordinator for the E-911 State of Utah Program Office. “In a panic, they call 9-1-1. But Several years ago, the Utah 9-1-1 Com - if you can tell them where to call, and put mittee partnered with an outside marketing that information in their hands beforehand, agency to launch a statewide educational they will be less likely to call (9-1-1).” program stressing the importance of remain- A second initiative—”Know Your Cell ing calm when calling 9-1-1 and the use of Well”—reminds residents that texting 9-1-1 non-emergency numbers when appropri- isn’t an option and to lock cell phones to cut ate. The multimedia campaign, themed down on “butt” and “purse” dialing. The num- “Help Us Help Out,” features a website, g aceachievers No Matter What’s Dealt Hialeah has another ACE up its sleeve

overseeing boards. “And it won’t stick if you don’t make maintaining and achieving excellence an integral part of the daily routine, and I do mean every day.” Quality improvement and assurance has to be part and parcel to every decision, both inside and outside the center, “not just for now but forever,” Guerra said, noting that slippage can seep into a center unnoticed and quiet like dry rot in a home’s foundation. “Quality doesn’t just happen to come by, it has to be invited, and welcomed, and tended to, and made part of a center’s environment.” The center didn’t have a lot of ground to make up in meeting the standards for becoming a tri-ACE, but it was bobbing below acceptable levels in how well dis - patchers were following the Medical Prior- ity Dispatch System™ (MPDS®) structured calltaking guide. Case review scoring was hovering around 90% adherence, but some tweaking was needed to stop a small, slow leak in keeping top scores aloft. Team Players Hialeah Public Safety Communications dispatchers (left to right) Anita Martin, Daniel Cabrera, and Doris Cuervo are “Again, the main fix to the adherence dedicated to ensuring the agency performs at accreditation levels and offers customers the best service possible. requirements was a buy-in from everyone dispatching center handles nearly 345,000 that it mattered,” Guerra said. “Everyone By James Thalman calls each year. Hialeah Director of Com - decided that it’s not about the score but what munications Chief Lazaro Guerra said the those case review scores mean to how well If emergency communicators can be on a tri-ACE designation was a point of pride we’re doing in responding to people in their roll, the public safety dispatchers in the city across the center. moment of need.” of Hialeah, Fla., are on one. “Not only does it show us that we’re Florida has been through a lot of changes In October 2009, separate dispatching actively seeking to be excellent in emergency the past seven or eight years—financial centers located six miles from each other response, technical capability, and the defini- upheaval and a lot of community ties that merged into a one-stop shop—a 3,000-square- tive example of public safety, it shows the bind with it, Guerra said. “We’re remaking foot communications center with 15 state- nearly 300,000 residents we serve that we’re and helping rebuild the confidence and con- of-the-art consoles—for 50 police, fire, and doing all we can to achieve those goals across nection in our community, and that makes us medical dispatchers. Less than two years all three agencies,” Guerra said. both proud and keeps us humble.” later, the City of Hialeah Public Safety The nationwide recession and the burst To achieve accreditation, Public Safety Communications Division became a triple- of the housing bubble six years ago hit Communications dispatchers must meet accredited emergency dispatch center by Florida particularly hard. Having a new and specific standards for certification and the the International Academies of Emergency improved communications center gives Hia- agency must submit an ACE application Dispatch® (IAED™). leah residents a kind of ace up their sleeve form along with a detailed, self-study of As part of the consolidation, a new com- when it comes to maintaining a new sense 20 specific categories. Accreditation is vol- puter-aided dispatch (CAD) system was of community as the economy continues untary and involves review of everything added, making the division one of the most to rebound, not just economically but in its from the center’s description to procedures effective comm. centers in the country as sense of community. outlining a quality improvement plan, con- well as one of three tri-ACEs in the world Obtaining the designation was well tinuing dispatch education, and compli - while residing in a state widely regarded as worth the effort, Guerra said, noting, “and it ance to the life-saving IAED ™ emergency the forward point of how emergency dis - does take effort.” To other agencies consider- dispatch protocols developed by Academy patching gets done. ing whether to go for it, “the decision to do Co-founder Dr. Jeff Clawson. Hialeah, the fifth-largest city in Florida, so must be a group decision. You don’t make Hialeah and other agencies that have is growing like a strand of bamboo, and the it if everyone isn’t on board,” including the taken getting and keeping ACE designa -

THE JOURNAL | March/April 2013 21 tion seriously all have unique ways In one way, if there was an Uber- of running and improving operations. Protocol for communication centers, But, they are indistinguishable when structured and continuous attention it comes to the one big thing common to quality improvement would be it, in centers that actually achieve it: Dale often tells students, staff, and Every person, full and part time, was veteran center supervisors. Quality on the team and pulling individually assurance and improvement is the from the start. real bottom line of any center. Not “It’s not showing off to the region engaging in reasoned, full-team qual- you serve, although being an ACE does ity improvement is like a sink without give a center an ego boost for sure,” a faucet or a clock without hands—not said Brian Dale, IAED™ Accreditation all that much help. Board chair. “It’s really more about Every center director or supervisor what you’re showing the folks inside shouldn’t be daunted when hearing the center. It’s really about the internal about a center becoming an ACE but Hialeah Public Safety Communications dispatcher Anita Martin workings and improving operations instead view it as an engraved invita- inside the control center, not control- tion to take quality improvement seri- ling overseers or public opinion.” ously, and accept it. Dispatching is like the front door of “It comes down to that single deci- your house—the parts you don’t notice, sion, and then a daily decision to keep Dale says. Without a well-seated and at it,” Guerra and every other ACE- square jamb and hinges and turnable designated center supervisor says in so knobs and locks, “a door is more wall many words. than door. It will move maybe, but it “It’s the easiest and hardest decision, won’t swing.” but it has to be a decision,” says veteran ACE designation is really a sworn, center supervisor Tom Norvelle. “It active commitment to providing the won’t happen by accident; accidents public the smoothest, efficient function- happen out there, not in here. And, it’s ing to handling the flow of information the definitive example of ‘Easier said from incoming call to coordinating out- than done.’ Then again, what in the g Hialeah Public Safety Communications dispatcher Daniel Cabrera going response vehicles. world isn’t easier said than done?”

Just Ahead

If you can’t be in Salt always extraordinary stories Lake City for NAVIGATOR we hear from dispatchers 2013, you can at least have the and—as best as we can—give opportunity to relive some of an overall scenic view of a the outstanding conference conference held in the city moments through stories where the whole thing about featured in the next issue of protocol started nearly 35 The Journal. Although we’ll years ago. But that’s not all. spare you a heavy song-and- The Journal will also include dance revue, risqué jokes, the standard favorites: con- and fashion commentary, tinuing dispatch education, we will be rolling out our Your Space, industry-related own brand of red carpet to news, and columns written introduce the people behind by experts in the emergency the many awards recogniz- communications profession. ing the Dispatcher of the And you won’t want to miss Year, the Dr. Jeff Clawson a chilling look at team “Shock Leadership choice, ACE and Thaw” as they brave the achievers, and CCM gradu- frigid waters of the Chatfield ates. As always, we will high- Reservoir in Colorado all in light the never ordinary and the name of a special cause. g

22 THE JOURNAL | iaedjournal.org g FAQ Ventilation 1st Pathway Is breathing problem use restricted to asthma?

Brett: 1. Selection of the overdose protocol for cols have been augmented in recent years to I am an EMD using the Advanced Medi- a patient reported as not awake and not accommodate arrests so that safety issues are cal Priority Dispatch System™ (AMPDS™). breathing. There is no arrest descriptor not overlooked. I answered a call in which the patient had in MPDS or ProQA®; however, in MPDS An OVERDOSE or POISONING is severe breathing problems due to chronic there is a DLS link for “Unconscious” and a bit of an anomaly because, technically, obstructive pulmonary disease (COPD). in ProQA the DLS link is for “Uncon - the substance taken is an “outside force,” The patient stopped breathing and I used the scious or Arrest.” Should we advise call- which is part of our dispatch definition of Ventilations 1st pathway to begin CPR. This takers to select Protocol 9: Cardiac or trauma. However, the actual mechanism or was marked incorrect and the reason given Respiratory Arrest/Death or Protocol 23: action on the body is more akin to a medi - was that this should only be used for asthma Overdose/Poisoning (Ingestion)? If the cal problem. Therefore, OVERDOSE or and the other conditions listed. Is this POISONING is widely considered a correct? If so, why is asthma the only medical emergency by DLS experts. breathing problem appropriate for V This is why there is no arrest Deter - 1st pathway? minant Descriptor on Protocol 23; Tracey Grouden, EMD Protocol 9 is appropriate if the Great Western patient is not breathing. Ambulance Service The Standards Council is of the Chippenham, U.K. opinion that the OVERDOSE or POISONING patient found in arrest Tracey: is not a potential scene safety risk, Your thought process was right so the call can be handled safely and regarding the use of the V 1st path - effectively using Protocol 9, and the way for COPD arrest. In fact, COPD patient can benefit from the result - will be added to the Protocol 6: ing ECHO response and expedited Breathing Problems suffixes and treatment. Post-Dispatch Instructions (inhaler/ The arrest link is included in nebulizer use) in v13 of the Medical ProQA simply to make sure the EMD Priority Dispatch System™ (MPDS®). gets to the right place if Protocol 23 Your e-mail serves as an important is selected. It was not included in the reminder to the Standards Council cardset because it would be mislead- to include COPD in the V 1st list of ing, and the unconscious or INEF - the Pathway Director on PAI-c. FECTIVE BREATHING and Not alert With that said, I cannot fault your links go directly to appropriate PAIs. ED-Q™ for making the scoring deduc- Your second question is a bit tion since this provision does not yet appear in easier to answer. The issue was raised by protocol. I hope you will share this e-mail with calltaker should select Protocol 23, please way of a Proposal for Change and was con- your ED-Q and use it as a learning experience. explain since there is no arrest descriptor. sidered in a Standards Council meeting for A patient with an acute exacerbation of COPD 2. In Protocol 6: Breathing Problems in rela- version 13. The result? “Other lung prob - resulting in cardiac arrest is best handled using tion to the Key Question about asthma, lems” was added to the Key Question and the V 1st pathway due to the hypoxic nature of would you recommend selecting an to the PDI regarding the use of an inhaler the arrest, just as is the case for a severe asthma answer choice of “yes” if the caller reports or nebulizer because these prescribed treat- attack that results in cardiac arrest. emphysema or COPD? ments are safe and effective for COPD Thanks for the excellent question and patients as well as asthma patients. congratulations on your insight into the case. Heather Rochefort While v13 is not yet out, you can safely Brett A. Patterson Quality Support Coordinator advise your EMDs to select “yes” if the caller IAED™ Academics & Standards Associate Clinical Governance Unit reports COPD in response to the asthma Medical Council of Standards Chair Sydney Ambulance Centre question. Just be sure to pass that informa- Eveleigh, New South Wales tion along to the responders as the Key Ques- Brett: tion answer in ProQA will inform as asthma. We have a calltaking workshop this com- Heather: Brett A. Patterson ing Monday and have two issues that we Typically, non-traumatic arrests are han- IAED Academics & Standards Associate would like to get clarified: dled using Protocol 9, and the trauma proto- Medical Council of Standards Chair g

THE JOURNAL | March/April 2013 23 g NAVIGATOR NAVIGATOR Elevated U.S. conference to peak in Salt Lake

THE PREMIER EDUCATIONAL CONFERENCE FOR POLICE, FIRE, AND MEDICAL DISPATCH NAVIGATOR Conference Coordinator won’t be occupied, but conference attend- By James Thalman Claire Colborn said April 16–19 will provide ees will be invited on guided tours. a unique conference experience both in loca- The structure, which is the first Net Zero The 2013 NAVIGATOR conference tion and content. The IAED/PDC ™ head- Energy public building in the country—it reaches new heights with a confluence of quarters recently relocated to a completely produces as much power as it uses—will topics, product demonstrations, speakers, renovated 9-floor, 72,000-square-foot build- meet a multitude of needs for Salt Lake City and views you can use, all in its native home ing in downtown Salt Lake City. The plate public safety, including consolidating the of true grit and grandeur. glass-dominated structure, which is about administrative offices of the police and fire The International Academies of Emer- two blocks from the original home office departments, centralizing dispatch, and act- gency Dispatch® (IAED™) and Priority Dis- and open to visit during the conference, is ing as a disaster/emergency operations cen- patch® were founded in Salt Lake City, a both the literal and metaphorical reflection ter. It replaces the tightly crammed building place that until the mid-19th century was of a company with a bright future. the agencies have occupied since 1958. the roaming and hunting ground for such Alan Fletcher, PDC president, said new Courses at the conference range from colorful figures as Jim Bridger and Jedediah company headquarters makes the Salt Lake how to survive shift work, to the power Smith, who explored, trapped, of peer case evaluations, to and mingled with native Indian how not to sink in the rising tribes including the Bannock, tide of digital data. A full list Shoshone, and Goshute. of course sessions, listed by Industry invariably changed track, can be found by visiting the landscape; development N Y www.emergencydispatch.org/ became king. Mountain men AVI IT NAVIGATOR. became the stuff of lore. Indians www GA KE C 13 NAVIGATOR wouldn’t .emergencydispatTOc 9, 20 R T LA 7-1 were pushed farther north and SAL be complete without a number west. Industry beckoning the h.org 25.5853 | April 1 of between-days and off-hours 8.7 “new immigrants” to a mile-high 13 88 socializing, including an official terrain drove Utah (statehood Opening Gala Reception and the achieved 1896) along a path of annual Closing Luncheon with alliance with innovation and an the Communication Center Man- international attention: ager (CCM) Graduation and the • Mormon settlers devised a method to irri- announcement of the recipient of gate the desert that is used in arid lands City NAVIGATOR a special occasion, and the Dr. Jeff Clawson Leadership Award. around the world to this day. the 2013 conference marks a defining point Keynote speakers include Jim Shea, Jr., between the organization’s three decades of gold medal winner in skeleton racing at the • The digital world became a reality in improving emergency dispatching across the 2002 Winter Olympics held in Salt Lake Salt Lake City and nearby Provo with world and the organization’s full realization City. Both his father and grandfather were pioneering word processing and com - of its role internationally. Olympian competitors. His father competed puter graphic design, from Pixar’s hop- “We couldn’t ask for a better location,” in Nordic combined and cross-country skiing ping desk lamp to the Apple iPhone 2012 Fletcher said. “We’re in the heart of a down- in the 1964 Winter Olympics in Innsbruck, app of the year. town that’s turning heads here and abroad. Austria. His grandfather won two speed skat- • A coalition of Mormon, Jewish, and We’re very excited about making the IAED ing gold medals in the 1932 Winter Olympics Catholic settlers built a public health and a visible part of the skyline as well as a vis - at Lake Placid, N.Y. safety network that could be a national ible partner of this city’s influence around Entertainer Jason Hewlett and the two model for a modern hospital/clinic sys- the world.” dozen or so famous actors and personalities tem of medical care if anyone in that field Also on display downtown, just a sev - who reside in him will be the Closing Lun- would take a closer look. eral block walk or a short TRAX light- cheon keynote speaker. The singer/piano rail train ride from the conference site, player/humorist is a Salt Lake native who That amalgam of collaboration is the is the city’s new Public Safety Building. tours the corporate convention circuit but foundation of IAED Co-founder Dr. Jeff The $125-million complex features what whose show is making wider ripples across Clawson’s idea of structured dispatch that at architects would like to be known as the the country. With a cast of character impres- last count is being used in nearly 3,000 emer- “centerpiece of emergency dispatching sions ranging from Nat King Cole to Led gency call centers in 43 countries staffed by worldwide.” The building will be in the Zeppelin, Hewlett’s show has been called 54,100 IAED-trained dispatchers. last week of its construction schedule, so it “unique,” “a blast,” and “funnier than heck.” g

24 THE JOURNAL | iaedjournal.org Two weeks that will change your life...

...without the obedience training

The CommuniCaTions CenTer manager Course online session begins: September 9, 2013 onsiTe: October 6-11 | December 8-13, 2013

“ The CCM course is much more than a constructive learning experience for communications center professionals…it is a reaffirmation of the value of the individual as a whole and the priceless gift of an entire new network of colleagues who have now become part of my extended family.”

—Sherri Stigler, Waukesha County Communications, Waukesha, Wis.

Presented by: Online registration for the 2013 course is now open. Fitch & Associates on behalf Go to www.emergencydispatch.org/certccmcourse of NAED or call Sharon Conroy at (816) 431-2600 for more course curriculum and registration information.

NENA has approved this course as credit toward recertification ™ for the Emergency Number International Academies of Emergency Dispatch Professional designation.

CCM_Ad_Nav2013Brochure.indd 1 3/6/13 11:25 AM g feature | Hurricane Sandy

Hell And High Water Sandy-swamped call centers rise above the storm

James Thalman

he world didn’t come to an end in December 2012 as the long- “We began prepping for worst-case scenarios starting on Sunday,” gone Mayan timekeepers had hinted it might some 5,000 years Guido told The Journal during a telephone interview. “When the calls ago, but for a big chunk of the United States it looked like it hit—and we were easily up 40% of normal right away—we had already Tmight when life along the Eastern seaboard was brought to a reassigned everyone to Emergency Medical Dispatching duties. We sudden, sodden stop by Apocalypse-sized Hurricane Sandy. had shut down all patient transfers and had all 110 available response As Sandy plowed through Battery Park in New York City at about vehicles staged and ready when it hit.” 8 p.m., Oct. 29, a 13.7-foot storm surge, pushed by 85 mph winds, Shutting down all but emergency operations is just about as pummeled seawater as high as the hem of the Statue of Liberty’s robes rare as a monster hurricane for NSHS. It is the largest hospital-based and put wide swaths of the Northeast coast temporarily below sea level. ambulance service in the New York metropolitan area and among the Hurricane winds fanned out across 1,100 miles—the largest largest in the country, with a catchment area of 1,700 square miles of diameter of an Atlantic hurricane in recorded history—and led New York City and Nassau and Suffolk Counties. It handles more emergency services responders on a weeks-long wild goose chase than 120,000 requests for service a year. across 24 states. The storm blew apart the daily routine like a “That kind of [call] bump is a big one for us, but we really felt Louisville Slugger beating dirt from a throw rug and, in a not-soon top of things and ready to handle anything,” Guido said, noting fond farewell, hooked up with a lingering rainstorm that spawned that the Medical Priority Dispatch System™ (MPDS®) “really made sidewinding blizzards in Virginia and Tennessee and left parts of handling the calls the easiest part.” Michigan and Wisconsin flapping in the breeze. The hardest part, Guido and dispatchers from Manhattan to At about 8:30 p.m., Oct. 29, power outage calls to the University Goshen, N.Y., agreed, was directing response vehicles around tree- of Medicine and Dentistry of New Jersey-Emergency Medical blocked or flooded roads. Communication System (UMDNJ-EMS) started going off like “We had hiccups here and there; the power would go off and on fireworks on the 4th of July. Call loads increased 30% to 45% above for the first little while, but the back-up generators kept us going the norm across the Northeast and stayed there. Great swells of smoothly,” Guido said. seawater lifted cars like so many tub toys and winds tore out old- The agency had stowed back-up protocol cardsets in plastic growth trees by the roots, flinging them across power and telephone bags and in a locked cabinet should power supplies to the consoles lines and generally sending anything not made of concrete or tightly suddenly give out. “We unlocked the cabinet, but that was as far as attached to it someplace else. we had to go into that back-up plan,” Guido said. Calls from the stranded, sinking, or suddenly sunk gave way to Communication center supervisors had stories about both their a flashflood of possible carbon monoxide (CO) poisoning calls due dispatching crews and responders matching the storm blow for to natural gas leaks and the large number of storm victims trying to blow with a joint effort to reach people. Dozens of times, emergency keep warm with poorly ventilated kerosene heaters and gas stoves. medical responders waded waist deep through the dire straits that a By midmorning, Tony Guido, a veteran dispatcher and IAED ™ few hours earlier had been their neighborhoods. certified quality assurance officer with North Shore Long Island Two NSHS hospitals are located in areas that, in heavy rains and Jewish Health System for Emergency Services (NSHS) in Syosset, especially in hurricanes, turn into a kind of Passaic wetlands that can N.Y., was into the 20th hour of what would be 90 hours straight muddy the routine transfer of patients among facilities. With an inside the communication center. increase in emergency calls of around 15,000 during the first two days

26 THE JOURNAL | iaedjournal.org Casino Pier Seaside Heights, New Jersey Photo by Master Sgt. Mark C. Olsen/U.S. Air Force/New Jersey National Guard National Jersey Force/New Air Olsen/U.S. C. Mark Sgt. Master by Photo

THE JOURNAL | March/April 2013 27 of Sandy, transfers were limited to neonatal/ pediatric moves determined to be a matter of life and death. “The call volume didn’t throw us because we had basically shut down all but emergency operations,” Guido said. “Coordinating calls and retriaging en route is habit around here, so we just went into overdrive mode. We never got ahead of the need, but we kept up with it for the worst part of the aftermath during the next three weeks.” The spike in calls reporting unconscious or semi-conscious or suspected CO poisonings involved people feeling sick with flu-like signs and symptoms. UMDNJ received more than a normal year’s worth of calls requiring Protocols 31: Unconscious/Fainting (Near) and 32: Unknown Problem (Man Down) during the first week. A “first and worst” incident involved two simultaneous CO poisoning deaths. Despite best efforts, two school-age girls in the same bedroom in Newark died as calltakers tried in vain to glean Key Question information from a highly emotional caller. The fire Just Missed A tree lays between two homes in Springfield, N.J., after being struck by Hurricane Sandy. department requested EMS for nearly every CO alarm call they were on “to evaluate” A fellow dispatcher whose home was world. Landlines worked for those who patients; if the firefighters got a reading on directly in the path of the storm stayed still have them, but because people depend their CO meters, they called for EMS. at Caiazzo’s place for a week to ride out on cell phones to the exclusion of landlines So-called “good intent” calls put a huge the storm and work his scheduled hours. and other forms of communication, it was initial strain on every communication center They listened to news using an iPad and a huge problem.” not only because of the high call volume but, RadioReference.com. Federal, state, and local public safety also, because of suspected poisonings that “We were in complete darkness with administrators as well as elected public were unfounded and caller refusal for care or only the glow of the iPad and some candles officials began continuous and urgent public transport, Guido and other supervisors said. listening to the terror unfold around us,” requests to dial 9-1-1 only in the event of Caiazzo recalled in an e-mail to The Journal. clearly life-threatening emergencies and to As far as the eye couldn’t see “It truly was scary. The radio calls never use social media networks and news media All of Newark, N.J., and the surrounding stopped … water rescues, fires, carbon for damage updates or to check on the status metropolitan area went dark at 6 p.m. on Oct. monoxide, traffic accidents, trapped vehicles, of family members and friends. 30. Floodwaters were filling roadways and wires down and arcing, people on oxygen subway tunnels, shorting out the power to who didn’t have backup when the power Whiplashed pretty much everything that runs on electricity. went out, people stuck in elevators, etc., etc., Dispatchers describe handling the initial Rescuing stranded or sinking motorists etc. Police, fire, and EMS were completely call traffic as something like trying to deal dominated emergency call traffic throughout overwhelmed despite extra staffing and all poker hands by throwing playing cards in the the New York City metropolitan area. the solid preplanning.” air, and the aftermath like juggling a bowling Outages lasted from three days to three Cell phones operated for a few hours ball, a sledgehammer, and a head of lettuce. weeks and many were man-made—Public then went dead. Caiazzo’s 4G service went to On Halloween, Mother Nature showed Service Electric and Gas Company 3G and then to 2G, 1G, and then to no data up on the doorstep of Orange County 9-1-1 intentionally cut power to many of its at all. Even though most of Newark’s cellular in Goshen, N.Y., dressed as hell and high water. substations along the flooding Passaic River. antenna sites are on top of commercial Veteran dispatcher and supervisor UMDNJ emergency dispatcher Ryan buildings, it wasn’t Sandy’s winds that took Melissa Alterio was girding up to face the Caiazzo, who was “unfortunately on vacation” them out but the lack of back-up electrical fourth but by far scariest hurricane of her during the peak of the storm, kept tabs mostly generators to keep their batteries charged. career. Floyd, Irene, and Lee had taught via cell phone by listening to Newark Fire and “Finally, there was no voice capability,” Alterio what Sandy would teach every Port Authority Police. When the power went he said. “By the next morning, a city that dispatcher: Hurricanes are like whiplash out, so did his Voice over Internet Protocol has over 150 cellular antenna sites had injuries in a car crash, with the actual (VoIP) line that’s part of his home cable TV virtually no cellular voice service and concussion coming when a center is slammed package but without battery back up. therefore no contact with the outside by calls in the immediate aftermath.

28 THE JOURNAL | iaedjournal.org “For a dispatcher, disaster recovery is just out a lot worse, said Jeff Pompper, executive A note to fellow as stressful and busy as when the storm is director of emergency services and the passing through,” Alterio said. “I don’t think emergency management coordinator in Salem dispatchers most people—the public that is—realize that. County, N.J., which had extensive damage but We received numerous calls for days later for not a single injury. flooding, power outages, generators running Was the center just well prepared or out of fuel, and individuals requiring oxygen. mostly lucky? And, we spent weeks dispatching mutual aid “It’s probably a lot of both,” Pompper to the more devastated areas of the state.” said. “But having a coordinated and willing Even with that self-imposed triage network of volunteers definitely helped; supposedly limiting 9-1-1 calls for situations at supplementing communications with the their worst, “[call] traffic was three times busier hundred or so tireless folks who were ready, than I’ve ever seen, and I’ve seen a lot of bad willing, and able—and able is the key.” storms,” Alterio said. “Irene was by far the most Communications in the aftermath memorable storm incident I’ve experienced of any emergency can be a problem, in my career. While our 9-1-1 team handled Pompper and other communication center Despite the 12/12/12 rock ’n roll concert themselves amazingly well during Irene, it also supervisors said, but it can be a train wreck at Madison Square Garden to raise funds assisted us greatly for preparation for Sandy.” on top of a big natural disaster unless for Hurricane Sandy relief, unsung that Part of that experience was the abiding emergency services are able to create night were the dispatchers who worked concern among dispatchers that their lives their own luck by plugging into an active long and without breaks answering the outside the center were being turned as volunteer network, regardless of how large flood of 9-1-1 calls that swamped PSAPs upside down as everyone else’s. or small their coverage area. throughout the region. “Many of them were just as fearful as the “Everyone was queued up and ready Tony Guido, a veteran dispatcher and callers we were dealing with,” Alterio said. “I to roll, but there was no point in sending an IAED-certified quality assurance officer think for everyone, the most difficult aspect them when we weren’t sure they could with North Shore Long Island Jewish Center was knowing our families and loved ones were get there and be reasonably safe once they for Emergency Services (NSHS) in Syosset, home, and perhaps somewhat vulnerable, and did,” Larry Fisher, Salem County chief of not able to be there with them or reach out to communications and 9-1-1 coordinator, told N.Y., said perhaps that’s how it should be. them when we would have liked to.” The Journal a month after the storm subsided. “We’re not really front and center but Surprisingly, no injuries were being we’re always there, and proud to be,” Guido Role reversal reported in the region, and even more said. “Keep in mind, not only did dispatchers Sandy changed Caiazzo’s view of 9-1-1. remarkable, no serious injuries occurred as handle the storm from their consoles, many A fight outside his apartment building the the full response and cleanup began in the took calls regarding their own houses.” night after the storm sounded serious and aftermath, Fisher said. “So, while it was the During the height of the storm, neigh- lengthy enough that he dialed 9-1-1. The worst storm we’d ever seen, no one being bors and fellow dispatchers texted photos call could not be completed and he never seriously hurt somehow in the biggest of homes owned by dispatchers showing got through despite numerous tries. Several storm anyone has ever seen is a record event damage ranging from flooding to total hours later he received a callback asking in its own right.” losses. Based on accounts of center about his “abandoned” call. Unfortunately, dispatchers rarely put supervisors in the New York City metropoli- “I was, for once, on the other side of the personal contingency plans into place, tan area, at least 20 dispatchers lost their fence, experiencing the frustration that our Caiazzo said. homes due to fire, wind, and rain. callers experience when they can’t get through “While 9-1-1 centers have contingency That’s why the 911 CARES project is or when the system just doesn’t work the plans for disasters and loss of communications, facilitating support and sharing needs way it should,” he said. “It was a sickening and most 9-1-1 telecommunicators don’t have their received from area public safety commu- helpless feeling that I, as a 9-1-1 dispatcher, own similar contingency plans for personal nications centers. Donations are still being instructor, and advocate couldn’t reach help communications, meals, and accommodations accepted, and a list of losses suffered in myself; it completely changed my worldview if their homes are destroyed, unpowered, the wake of the storm shows the need will on 9-1-1 as a system, not just a number. and inaccessible for any period of time,” continue for some time. 911 CARES asks “We 9-1-1 dispatchers often forget and Caiazzo said. “Sandy should teach us that that donations be sent to: disregard the emotional component that preparation and preplanning on behalf our callers experience when they witness an of the communication center needs to FDNY Communications event and try to obtain help only to come translate down to the personal level too. If Attn: FAYE/SANDY RELIEF up against myriad barriers that stretch from you don’t have a way to rest, have shelter, or 83-98 Woodhaven Blvd technological issues to painful, structured to prepare meals, you’re not going to be very Woodhaven, NY 11421 ‘robotic’ screening,” Caiazzo added. effective at work.” g Monetary donations can be made Lessons learned More about Hurricane Sandy online via 911 CARES at www.911cares. The quick and sustained use of volunteers at www.iaedjournal.org com, where continuing updates are posted. was a key reason the situation didn’t turn

THE JOURNAL | March/April 2013 29 g feature | Oregon Shooting

Loving Embrace A couple embraces after they were released from the Clackamas Town Center in Portland, Ore. Two people were killed and at least one other was shot at the mall on Dec. 11, 2012. Photo by Thomas Boyd/The Oregonian Boyd/The Thomas by Photo

30 THE JOURNAL | iaedjournal.org Shooting Spree Clackamas County responds to lone gunman at shopping mall

Audrey Fraizer

e was young, had worked in a sandwich shop, and, fortunately “My staff did amazing work,” he said. “They had so much being for the thousands of Christmas shoppers at the crowded Port- thrown at them at one time for a very long time, and they just kept land, Ore., mall, his semi-automatic rifle jammed. at it. The center was as calm as I’ve ever seen it. There was extreme H The possible interval the breakdown destined between focus. They were operating as if they were one person. Incredible.” shots might be the reason 22-year-old Jacob Roberts took his own life, Spross was paged when the first call came in at 3:29 p.m. and ending the apparent random attack that left two dead and one wounded. responded to the dispatch floor. “As bad as it was, it could have been worse,” said Ryan DesJardin, Six dispatchers assigned to the police and fire radios jumped technical manager, Clackamas County (Ore.) Communications. into action, informing emergency responders that an active shooter “When anybody dies violently it is a tragedy, and I send my condolences incident was reportedly in progress. Within minutes, every single line to the families. But we’re lucky that more people weren’t killed.” at the center was in use. DesJardin was off duty on late Tuesday afternoon, Dec. 11, when “The cell trunks were saturated,” said DesJardin, who was paged Roberts entered the busy mall wearing a load-bearing vest over his and on his way to the center moments after the shooting started. darkly colored clothing and carrying an AR-15 and several magazines “We’re a mid-size agency [six dispatchers/shift, maximum staffing full of ammunition. A white hockey mask covered his face. level] but it would be difficult for most centers to staff up 24 hours According to police reports, Roberts opened fire in the second- [a day] for this type of incident.” level area in front of the Macy’s department store facing the food Within five minutes, 50 calls were in the primary calltaker’s court, fatally wounding Cindy Ann Yuille, 54, a hospice nurse, queue. The number doubled less than five minutes later, according and Steven Mathew Forsyth, 45, who ran a custom coaster-making to Spross, who compiled the data shortly after the incident in business at the mall. A third victim, 15-year-old Kristina Shevchenko, anticipation of media questioning. was shot at an unknown location, but was able to make it outside “We had one caller who was a witness to the suspect but most the mall on her own. Once Roberts’ automatic weapon supposedly people called asking what they should do,” Spross said. “We couldn’t jammed, he hurried past the food court, descended a service stairwell, provide a lot of information and all we could tell them was to find and shot himself. His body was found approximately 12 minutes a safe spot if evacuation was impossible. Given the situation, the after the shooting started. majority of our callers sounded really calm.” Police and mall officials attributed the malfunctioning gun and The initial response of sending a single medic and two engines a one-day training seminar held the past spring that was given by quickly accelerated as callers revealed the scene of a lone gunman Clackamas County sheriff’s deputies for the limited number of running at large and people scrambling frantically for the mall’s exits casualties. According to local news reports, police had staged active or taking cover. The first deputies arrived within one minute of the shooter scenarios for the mall’s unarmed security staff and provided first radio alert, with a massive ensuing call-out bringing more than advice to mall tenants for how to respond in such an emergency. 100 police from federal, state, and local agencies. Clackamas County Communications Operations (CCOM) Manager Along with Clackamas County Sheriff’s Department’s regional Mark Spross also credited his staff during the desperate situation. partners, Clackamas Fire District #1 arrived, along with members

THE JOURNAL | March/April 2013 31 Photo by Thomas Boyd/The Oregonian Boyd/The Thomas by Photo Tactical Team Members of a tactical team head through a parking lot at the Clackamas Town Center as darkness falls. of the Portland Police Bureau, Oregon State Two hours into the incident, Dispatcher Since the time lag for stress, when it Police, the Federal Bureau of Investigation, Brenda Fahey jumped into her car for the does occur, can vary from the same day to and the Bureau of Alcohol, Tobacco, 20-minute drive to the CCOM from the days later and affect even those not present Firearms, and Explosives. Portland City Dispatch Center. She picked during the incident, the CCOM offered 9-1-1 calls continued well past an up coffee and pastries, compensating for the debriefings for anyone at work or not. incident that lasted 12 minutes between food breaks no one could take. “Everyone had a connection to what was the time Roberts started shooting Fahey is a member of Portland City’s going on,” Spross said. “I don’t care where and police discovered his body in the Critical Incident Stress Management (CISM) they were at the time. When things like this stairwell. Incoming calls saturated cell team, and this was the first time in her 11 happen, everyone is affected.” tower lines, pushing overflow to nearby years of working in communications to offer The shooting was the largest incident the centers, including the City of Portland support away from her home center. Although center had handled both in terms of people communications center. the CCOM appeared calm when she arrived, involved and call volume. An estimated The volume relating to the shooting she had Spross’ permission to assess signs of 10,000 people were at the mall at the start of plus other emergencies going on—such as stress in a group of people that commonly the incident, and between the hours of 3 p.m. traffic accidents—activated an all-call alert to denies they’re bothered by what’s going on. and 7 p.m., calltakers answered 365 combined communication staff. Fortunately, the timing “If someone is crying or looking cell and landline 9-1-1 calls. near shift change meant dispatchers were distracted, we’re trained to help diffuse those Two days later, a lone gunman killed 26 already on their way to work. emotions,” she said. “It’s all very confidential. people—six adults and 20 children between “But it didn’t take the all-call to get people We talk to the individual to see what can be the ages of 6 and 10—at a grade school across here,” Spross said. “Staff dropped what done. It might mean suggesting the person the country. they were doing once hearing early reports goes home or, at least, takes a break.” “The second shooting made our shooting coming over the radio [media].” The “in the moment” CISM counseling hit home for a second time,” Fahey said. “We Within an hour of the first call, all 14 is followed up the next day; if the stress can only imagine how those dispatchers were seats were filled, and those who didn’t get continues, the CISM member will suggest feeling. Bad things like this affect our entire a seat helped out in other ways. In addition referral to a specialist. community.” to answering calls, crews monitored the two Once the incident ends, and the pace A line of silver and red stars offering police and one fire net set up at the scene and settles down, that’s when stress can really raise words of support for retailers and shoppers took turns at calltaking and dispatch. Spross its ugly head. Spross compared the aftermath were hanging from the glass railing near the concentrated on coordinating the situation— to driving in a car on a freeway while mindful Clackamas Town Center food court when notification to other agencies, assistance to of a tornado bearing down on your path. it reopened for business on December 14. supervisors, and emergency management— “The tornado passes and you’re out of The stars were available for customers to and making sure staff was able to stay in danger,” he said. “You’re tense. The situation sign and officials are reportedly considering control despite the intense stress. is over but the body reacts.” a permanent memorial. g

32 THE JOURNAL | iaedjournal.org g Medical CDE g police CDE OnTrack g medicalCDE Trauma Is Inside And Out MOI key to determining likely internal injuries

Any vehicle-related collision—be it in a distance from the incident and beyond the By James Thalman and Cynthia Murray Formula One race at 300 mph or a sudden sight of the dispatcher, the dispatcher must stop between kid-driven shopping carts— base his or her evaluation on the history and During this past Christmas shopping sea- involves the release of kinetic energy. The other more subtle pieces of information son, a Buffalo, N.Y., mom turned back to the exchange of those forces is what causes both given by the caller.” bolts of the red-balloon-bedecked flannel in the external and any internal injuries as the Determining when MOI takes prece - the center ring of a local craft store just as energy is transferred and absorbed. dence over known or obvious external her 4-year-old daughter was turning a pint- injuries is crucial in identifying the most sized shopping cart the toddler had pestered The ripple effect appropriate Chief Complaint Protocol, to push “all by myself” into a battering ram. Falls, crashes, and sudden deceleration response, and Post-Dispatch Instructions Out of sight, but coming just as incidents on any scale follow specific laws of (PDIs) to meet the needs of the patient. intently from the opposite direction, was physics and have their own MOI. That’s why Becoming skilled in deciphering the most an orange-punch-fueled Lancelot who some of the MPDS® traumatic incident pro- significant variables in these situations goes a had just feasted on two six-piece chicken tocols are designed to pose questions that are long way to facilitating better patient safety, McNugget orders at a 5-year-old’s birthday incident-based (rather than symptom-based triage, and care. party at the McDonald’s across the park - or even medical in nature), such as “How far Though the example of a collision of two ing lot. As the two each pushed their carts did s/he fall?” and “How did this happen?” shopping carts isn’t considered a high-mech- from lope to full gallop, the mom noticed These questions are also more natural anism incident, when dealing with trauma that the other fast-approaching steed was to callers reporting a traumatic incident, as triage protocols, it’s best to err on the side of mounted by a 2-year-old in the cart, facing they can describe what happened but may patient safety, Dale says. Remember the Sec- backward but craning forward. She got the not yet know the severity of injures or even ond Law of Medical Dispatch states: “When jousting officially started with a scream whether or not the people involved are con- in doubt, send ’em out.” that brought the hustle and bustle—not to scious or breathing. When a body encounters sudden decel- mention the hearts—of every customer in On the surface, the term “mechanism eration forces, “the injuries aren’t in what the the place to a screeching halt. of injury” appears to be just a fancy way caller hears or in what the responders can see, The trilogy of tykes collided with a force of describing what happened, but under - but how the organs have fared as the energy that witnesses said could have stood a bum- standing the incident is vital for a pre-hos - passed through,” Dale says. per car on its nose. An EMD-dispatched siren pital emergency care provider to assess the Less-than-obvious damage to the brain, soon drowned out the wail of the victims, impact on the patient’s body and develop an kidneys, heart, and lungs can be factors in who, fortunately, had been shocked breath- appropriate level of concern for the poten- assessing internal injury accurately. Trau- less but not seriously injured in the incident. tial of injuries. For instance, vehicle versus matic forces can cause the liver or its sur - “Everyone thinks that automobile acci- pedestrian incidents exemplify how MOI rounding tissues to be separated or sheared, dents are the No. 1 cause of injury and death outweighs the apparent seriousness of the resulting in significant internal bleeding. to children under age 14, and they’re right,” patient’s injuries described to the EMD. Additionally, a traumatic incident may says Brian Dale, chairman of the International Though severe injuries may not be visible, an sever the connection to the aorta, result - Academies of Emergency Dispatch® (IAED™) impact of that nature may cause slow inter- ing in severe respiratory distress. However, Council of Standards. “But the inertia of shop- nal bleeding or a developing head injury for these critical internal injuries cannot be ping carts piloted by energetic but inexperi- which symptoms have yet to manifest. observed visually. enced toddlers—who are let go by their parents “MOI is how we can begin to mentally “This is why obtaining specific infor - or who simply take off in a store—can lead to reconstruct the scene or incident and deter- mation from the caller is critical,” Dale shopping cart disasters that might be small- mine if the mechanism was significant,” says. “On Protocol 29 [Traffic/Transporta- scale but are still a catalyst for implementing Dale says. “Because Emergency Medical tion Incidents], we ask whether anyone MOI [mechanism of injury] approaches.” Dispatching occurs over the phone and at a was thrown from the vehicle, and we col -

THE JOURNAL | March/April 2013 33 lect information on whether the incident EMDs is the First Law of Medical Dispatch: infant. A rule of thumb for EMDs handling involves a pedestrian, motorcycle, or bicy- “First, do no harm.” such incidents is the younger the child, the cle.” These scenarios are considered HIGH- A child getting stuck in a shopping cart is more severe the potential for injury. MECHANISM incidents that suggest severe a minor trauma most parents have dealt with “On Protocol 17 [Falls], we ascertain what injuries and require a DELTA-level response. at least once, and without their child sustain- caused the fall [potential medical or safety Persons who are pinned or trapped in a ing a serious injury. However, outcomes can conditions], and most importantly, how far vehicle collision also require a DELTA-level be far more serious than people might think. the individual fell,” Dale says. “Once again, response, but are not considered HIGH- In 2005, an estimated 24,200 children were the EMD is evaluating and treating the MOI MECHANISM incidents as entrapment treated in U.S. hospital emergency depart- surrounding the traumatic event.” accounts for a lower number of significant ments due to injuries sustained in or around Dispatchers don’t necessarily need to injuries than ejection from a vehicle. store shopping carts. Most of those inci - understand the principles of kinetic energy or This past January, a New York City mom dents—85%—involve children under age 5 and other laws of physics to properly handle falls, was checking out at her local supermarket primarily resulted from a child falling out of collisions, and other traumatic incidents, but when she checked the status of her 3-year-old a cart, a cart collision, or a tip-over. they should be aware of the forces at work in daughter for the 40th time and noticed that Shopping carts are inherently top-heavy determining the most appropriate response. her knee had become wedged in the fold-up and are even more so with a toddler aboard. One law always figures in—Newton’s First back of the cart and the frame of the cart. The V-shape array of the wheels (the back Law of Motion: An object in motion contin- The child’s whimper quickly became a four- wheels are farther apart than the front) makes ues in motion with the same speed and in alarm wail as her mom calmly and without carts even more inclined to tip. A stuck child the same direction unless acted upon by an too much pressure tried to pull her leg free. wanting desperately to be unstuck, and a par- unbalanced force. Applying this law and the The checkstand clerk, a store manager, and ent aiding in that effort, can turn a minor emer- principles of kinetic energy to traumatic inci- a security guard responded and provided gency into a major injury if the cart falls over. dents, the EMD should understand that the assistance that was the opposite of help. “Get According to Pediatrics, the research jour- bigger the object and the faster it’s going (or some Crisco!” “Don’t touch it!” “Call 9-1-1!” nal of the American Academy of Pediatrics, the farther the patient falls), the greater the The panic-stricken mom yelled for someone shopping cart–related injuries to children chance of severe injury. to get a bolt cutter. are common and can result in severe injury One of the top five questions dispatch- As the ambulance arrived, the knee had or even death. Injuries to the head and neck ers ask IAED instructors in training is why been freed. The child had sustained bruises, represent three-fourths of cases. a maximum response is sent when a patient a few scratches, and a big scare. Things could Dale points out that a small child in a vehicle accident or a long fall is report- have turned out a lot worse. strapped to a cart that falls over will travel ing only minor injuries. Dale points out “Of prime concern to the EMD is that two to three times his own height before that EMDs, along with their field provider the individuals on scene not be allowed to hitting the ground. When an adult falls a counterparts, will treat the MOI, regardless do something that they believe will help, distance of three times his own height, the of known injuries. The patient is “at risk” but that can or likely will exacerbate exist- incident is considered a “LONG FALL” (10– until an on-site assessment proves otherwise. ing injuries or even cause primary injury to 29 feet), which may indicate severe injuries. “The only way to protect the system and our the intended rescuer,” Dale says. To account for size differences, a LONG patients is to complete a thorough interroga- An appropriate safety guideline for FALL is defined as only 6–29 feet for an tion of all callers reporting such incidents.” g

34 THE JOURNAL | iaedjournal.org YOU MUST BE MEDICAL CERTIFIED TO TAKE THIS QUIZ. CDE Quiz Mail-In Answer Sheet CDE-Quiz Medical Answer the test questions on this form. (A photocopied answer Answers to the CDE quiz are found in the article “Trauma Is Inside And Out,” which starts on page 33. sheet is acceptable, but your answers must be original.) Take this quiz for 1.0 CDE unit. We will not process altered sizes.

1. What is the No. 1 cause of injury and death to children under age 14? A CDE acknowledgement will be sent to you. (You must answer 8 of the 10 questions correctly to receive credit.) a. shopping cart incidents b. traumatic falls Clip and mail your completed answer sheet along with the c. automobile accidents $5 NON-REFUNDABLE processing fee to: d. sudden cardiac arrest The International Academies of Emergency Dispatch 110 South Regent Street, Suite 800 2. Some of the MPDS traumatic incident protocols are designed to pose questions that are ______, Salt Lake City, UT 84111 USA such as “How far did s/he fall” and “How did this happen?” Attn: CDE Processing a. symptom-based (800) 960-6236 US; (801) 359-6916 Intl. b. medical in nature c. commonly expected Please retain your CDE acknowledgement d. incident-based for future reference. Name ______3. vehicle versus pedestrian incidents exemplify how mechanism of injury (MOI) outweighs the apparent seriousness of the patient’s injuries described to the EMD. Organization______a. true b. false Address______

4. When dealing with trauma triage protocols, it’s best to err on the side of: City ______St./Prov.______a. responder safety. b. patient safety. Country ______ZIP______c. bystander safety. d. none of the above Academy Cert. #______

5. Internal organ damage to the brain, kidneys, heart, lungs, liver, and aorta can be visually observed in the patient. Daytime Phone ( )______a. true b. false E-mail ______

6. Which of the following scenarios is considered a HIGH-MECHANISM incident? Primary Function a. ejection b. auto-pedestrian Public Safety Dispatcher (check all that apply) c. auto-bicycle/motorcycle _____Medical _____Fire _____Police d. all of the above Paramedic/EMT/Firefighter 7. The First Law of Medical Dispatch is: Comm. Center Supervisor/Manager a. A thing not looked for is seldom found. b. First, do no harm. Training/QI Coordinator c. Don’t be in doubt so much. Instructor d. Don’t take more victims to the scene. Comm. Center Director/Chief 8. In 2005, an estimated ______children were treated in U.S. hospital emergency departments due to Medical Director injuries sustained in or around store shopping carts. Commercial Vendor/Consultant a. 20,400 b. 22,400 Other c. 24,200 d. 26,400 ANSWER SHEET G MEDICAL 9. Three-fourths of the injuries sustained in shopping-cart incidents affect the patient’s: March/April 2013 Journal “Trauma Is Inside And Out” Please mark your answers in the appropriate box below. a. central organs. b. head and neck. 1. o A o B o C o D c. peripheral areas. d. fingers and toes. 2. o A o B o C o D 3. o A o B 10. The EMD should evaluate and treat the ______surrounding the traumatic event. a. mechanism of injury (MOI) 4. o A o B o C o D b. patient assessment c. priority symptoms 5. o A o B d. time of onset 6. o A o B o C o D 7. o A o B o C o D 8. o A o B o C o D 9. o A o B o C o D 10. o A o B o C o D To be considered for CDE credit, this answer sheet must be received no later than 04/30/14. A passing score is worth 1.0 CDE unit toward fulfillment of the Academy’s CDE requirements. Please mark your responses on the answer sheet located at right and mail it in with your processing fee to receive credit. Please retain your CDE letter for future reference. Expires 04/30/14

THE JOURNAL | March/April 2013 35 g policeCDE Harm’s Way Caller In Danger Protocol guides caller to safer place

with him or her while getting to safety, the EPD ger; however, it is important to note that the By Jaci Fox instructs the caller to put the phone down and CID Protocol should not be used until after call back from a safe location, if possible. dispatch has been initiated. It is essential to In police calltaking, safety is our No. 1 In some cases, the caller may not be able first get responders on the way to provide priority and the central focus of our higher to leave without facing potential danger, in protection and assistance for the caller. commitment to excellence. The Police Pri- which case the EPD encourages the caller to In version 4.1 of the PPDS, a new ECHO ority Dispatch System™ (PPDS®) provides communicate only if s/he is able to do so determinant was added as a send point on several specific instructions and pathways to safely. If the caller cannot speak freely, nor Case Entry for a CALLER IN IMMINENT address the issue of safety, whether regarding communicate otherwise, the EPD will stay DANGER discovered at the onset of the the safety of an officer, a caller, or the general on the line as long as necessary. If the caller call. This early send point allows the EPD public. This article will discuss, in particular, is able to speak freely, the EPD returns to the to initiate a 100-E-1 response, provide PDI-a, Pre-Arrival Instruction (PAI) Protocol C: main interrogation sequence and continues to and go immediately to the Caller In Danger Caller In Danger (CID) and the Post-Dis - obtain critical information for the incident. Protocol, bypassing the Chief Complaint and patch Instructions (PDIs) on that protocol. Certain rules stipulate when and how to addressing the caller’s safety first. “CALLER The specifically scripted instructions on Pro- use the CID Protocol. The CID Protocol may IN IMMINENT DANGER” is defined as: tocol C: Caller In Danger are aimed to guide a be accessed at any point in the interrogation “A situation that places the caller in caller from a potentially dangerous situation to when circumstances or caller statements immediate danger of death or serious injury a safer place. If the caller cannot take the phone indicate that the caller is in immediate dan-

36 THE JOURNAL | iaedjournal.org that does not involve a sinking vehicle, Though this may sound like a simple Stein stayed on the line after transferring vehicle in rising floodwater, stuck accelera- solution, we all know that EPDs are condi- the call to police in Washington, D.C., and tor, ACTIVE ASSAILANT (SHOOTER), tioned by habits and that they are not in the explaining the interrogation method to that bomb found, mental disorder (suspect habit of constructing simple yes or no ques- dispatcher. This now three-way communica- caller), or suicidal person/attempted suicide tions outside of the scripted protocol. How- tion provided the destination for officers to (suspect caller).” ever, this call—a portion of which is available attend to the caller’s needs. Stein reassured on YouTube—is incredible. Stein breaks the the caller that help was on the way and that The situations listed as exceptions in this questions down to the molecular level. someone would stay on the line until that definition (sinking vehicle, vehicle in rising Continuing on Panel 6, if the caller can- help arrived. floodwater, etc.) do, in fact, pose a real threat not answer yes or no questions audibly, as in to the caller, but are better handled on more this case, the EPD asks, “Can you tap on the Exceptional practice specific protocols to provide explicit instruc- phone 1 time for yes, 2 times for no?” During These tenuous CID situations are rare tions tailored to each situation. exceptions that require innovative thinking. Whether the CID Protocol is used during Because the silent caller scenario is not often Case Entry or Key Questions, it is important practiced as part of continuing dispatch edu- that the EPD be familiar with how to use this Whether the CID cation, the EPD may not be familiar with the PAI Protocol. Protocol is used tools that would enable the smooth processing of such an unusual, high-acuity call. You Navigating Protocol C: Caller In Danger during Case Entry can try one of the following ideas to practice Protocol C: Caller In Danger is a Pre- this skill in your communications center: Arrival Instruction Protocol designed using or Key Questions, • Practice using the CID Protocol with panel logic, just like any other PAI. Each another EPD. Adapt a written training panel includes a question such as “Are you it is important scenario, or create your own and test it able to get yourself to safety?” or “Can you out. This exercise provides valuable expe- take the phone with you?” The caller’s pos- that the EPD is rience and familiarity with a different sible responses are listed with directors indi- style of interrogation. cating which panel to go to next. familiar with how The Caller in Danger Protocol operates • Try ordering a pizza using only yes or no like any other PAI in the IAED ™ protocols. to use the PAI. questions (within the practice arena of However, on rare occasions, it may require your center, of course—not from a real the EPD to use creative thinking to handle business). You could even set this up as situations where callers are limited in what this particular interrogation, the caller did a group competition to see which pair of they can safely say (or otherwise indicate) not “tap” on the phone, but, rather, pushed EPDs gets the right order down first. on the line. one of the phone’s buttons: one tone for “Yes” • Review and take notes on Stein’s call as an The May/June 2012 issue of The Jour- and two tones for “No.” Stein was quick to example of how Panel 6 of the CID Proto- nal detailed a call taken by William “Will” understand what was happening without the col can be used. A real-life situation gives Stein of Prince George’s County (Md.) 9-1-1 caller saying a word. At approximately two new EPDs something tangible to remember that was a stellar example of handling a minutes, the caller indicated the first “Yes” in and use as another tool in their toolbox. CALLER IN IMMINENT DANGER situ- answer to his question, “Are you in danger?” • Another great training idea is to play a ation with quick, clever thinking balanced In less than four minutes of using this game called “Yes/No,” which is aimed with patience and competence. interrogation method, Stein learned that to develop a person’s deductive logic, When Stein answered the call and began the caller was home alone, that she did not ultimately preparing for the silent caller the Case Entry Questions, he received no live in an apartment complex, and that she scenario. Here is how it works: One lead answer. Though unclear at the time, the heard someone on the same floor as her bed - player mentally chooses an object that is caller [later identified as a female] could room where she was hiding. When Stein real- in plain view of all of the players. The rest detect the presence of an intruder in her ized that he’d accidentally asked more than of the players take turns trying to guess home and was certain that she was in danger. one question at a time, he backed off and the object by asking only yes or no ques- Her predicament was so precarious that she repeated questions singularly. tions. If the lead player answers “Yes,” to a could only whisper three times during a call The absolutely spot-on part of this call question, the player who asked the ques- lasting well over 13 minutes. was Stein’s creative approach to obtain the tion may continue questioning until the At the onset, Stein tried to determine the address. The caller pressed the phone button lead player’s response is “No,” at which location/address of the caller. Receiving no twice to a Prince George’s County address point the next player may begin ques - response, he stayed on the line, noting that and once to a home in Washington, D.C. tioning. The game ends when a player the caller’s measured breathing was audible Stein then asked the caller, “Beep the first correctly guesses the object; he or she can at one minute and 30 seconds. It was obvi - number of your street; beep the number of choose the next object for another round. ous that the caller could not readily com - times for the first number in your address.” Try it! You might be amazed at just how municate this information, so Stein moved This is brilliant! difficult it is to narrow the playing field directly to Panel 6 of Protocol C, which asks, The caller/EPD team communicated all with only yes or no questions. “Can you answer yes or no questions?” four digits in the address and then the street.

THE JOURNAL | March/April 2013 37 These instructions vary Safeguarding the caller tion” tab. This pathway has been simplified according to the situation, Post-Dispatch Instructions are a critical in Police ProQA Paramount, which provides instructing the caller to: component in safeguarding the caller, and easier access to a direct DLS Link to the these specific instructions should not be Caller In Danger PDIs. • get away and call back from overlooked on the CID Protocol. Whether using cardsets or ProQA soft- somewhere safe The EPD should give these instructions ware, the EPD must ensure that he or she is when possible and appropriate, though obvi- well practiced and adept at navigating the CID • keep very quiet and stay out ously not all of these instructions are appro- Protocol. Remember, caller safety depends on of sight priate for every situation. The EPD should the EPD’s proficiency in using the tools to pro- carefully consider the caller’s situation when vide the highest standard of care. There is no • avoid contact with the deciding which PDIs to give. Inapplicable time to practice or second-guess what needs to individual PDIs could put the caller in greater danger. be done when a real caller is in danger. • lock the doors and windows In some situations, the EPD may leave the CID Protocol to return to Key Question Note: The IAED held a special Locator Diagnos- • let the EPD know if the interrogation. After completing Key Ques- tic Tool Standards Committee meeting in 2010 individual leaves or returns tions and providing the PDIs on the appro- to discuss a diagnostic tool to address callers priate Chief Complaint Protocol, the EPD who don’t know where they are or who are sick • speak only softly to the should return to the CID Protocol to give or under duress and unable to communicate ver- individual if necessary appropriate PDIs there. bally. A draft version of this diagnostic tool is When using “Legacy ProQA ®,” this under development to run in ProQA Paramount. • observe the individual requires going back to the CID Protocol The exact release date of the diagnostic tool has continuously if safe to do so and clicking on the blue “Special Informa- not yet been determined. g

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Learn more about the sessions, courses, workshops, and exhibits at www.nena.org/nena2013 YOU MUST BE POLICE CERTIFIED TO TAKE THIS QUIZ. CDE Quiz Mail-In Answer Sheet CDE-Quiz Police Answer the test questions on this form. (A photocopied answer Answers to the CDE quiz are found in the article “Harm’s Way,” which starts on page 36. sheet is acceptable, but your answers must be original.) Take this quiz for 1.0 CDE unit. We will not process altered sizes.

1. The Caller In Danger Protocol is considered a Pre-Arrival Instruction Protocol. A CDE acknowledgement will be sent to you. (You must answer 8 of the 10 questions correctly to receive credit.) a. true b. false Clip and mail your completed answer sheet along with the $5 NON-REFUNDABLE processing fee to: 2. The CID Protocol may be accessed at any point in the interrogation when circumstances or caller statements The International Academies of Emergency Dispatch indicate that the caller is in immediate danger only: 110 South Regent Street, Suite 800 a. after dispatch has been initiated. Salt Lake City, UT 84111 USA b. before dispatch has been initiated. Attn: CDE Processing c. after the caller satisfactorily answers all of the Key Questions. (800) 960-6236 US; (801) 359-6916 Intl. d. after providing PDIs. Please retain your CDE acknowledgement for future reference. 3. In version 4.1 of the PPDS, a new ECHO determinant was added as a send point on Case Entry for which of the following situations? Name ______a. Bomb Threat b. Mental Disorder Organization______c. CALLER IN IMMINENT DANGER d. all of the above Address______

4. “CALLER IN IMMINENT DANGER” is: City ______St./Prov.______a. an ECHO determinant on Case Entry. b. a situation that places the caller in immediate danger of death or serious injury. Country ______ZIP______c. a situation that does not involve a sinking vehicle, vehicle in rising floodwater, stuck accelerator, ACTIVE ASSAILANT (SHOOTER), bomb found, mental disorder (suspect caller), or suicidal person/ attempted suicide (suspect caller). Academy Cert. #______d. all of the above Daytime Phone ( )______5. The CID Protocol is designed using: a. panel logic. E-mail ______b. mandatory instructions. c. informal directors. Primary Function d. concluding pathways. Public Safety Dispatcher (check all that apply) 6. Which panel on the CID Protocol asks “Can you tap on the phone 1 time for yes, 2 times for no?” _____Medical _____Fire _____Police a. Panel 2 Paramedic/EMT/Firefighter b. Panel 4 c. Panel 6 Comm. Center Supervisor/Manager d. Panel 8 Training/QI Coordinator

7. The Post-Dispatch Instructions on the CID Protocol include locking the doors and windows, letting the EPD Instructor know if the individual leaves or returns, and observing the individual continuously if safe to do so. Comm. Center Director/Chief a. true b. false Medical Director Commercial Vendor/Consultant 8. All of the Post-Dispatch Instructions on the CID Protocol are appropriate for every situation. Other a. true b. false ANSWER SHEET ? POLICE 9. After completing Key Questions and providing the PDIs on the appropriate Chief Complaint Protocol, March/April 2013 Journal “Harm’s Way” the EPD should: Please mark your answers in the appropriate box below. a. proceed to the Case Exit Protocol. o o b. end the call on Panel 3 of the CID Protocol. 1. A B c. stay on the line. 2. o A o B o C o D d. return to the CID Protocol to give appropriate PDIs there. 3. o A o B o C o D 10. ProQA Paramount provides easier access for the EPD to: 4. o A o B o C o D a. link to the Caller In Danger PDIs. b. put the caller on hold while reconfiguring the data. 5. o A o B o C o D c. go back to the CID Protocol and click on the blue “Special Information” tab. d. navigate the casual conversation pathway. 6. o A o B o C o D 7. o A o B 8. o A o B 9. o A o B o C o D 10. o A o B o C o D To be considered for CDE credit, this answer sheet must be received no later than 04/30/14. A passing score is worth 1.0 CDE unit toward fulfillment of the Academy’s CDE requirements. Please mark your responses on the answer sheet located at right and mail it in with your processing fee to receive credit. Please retain your CDE letter for future reference. Expires 04/30/14

THE JOURNAL | March/April 2013 39 g dispatch in action g off hours YourSpace g dispatchinaction Think Multitasking Shovels and CAD are everyday tools for Valdez dispatcher

S’no Place Like Valdez Snow, and lots of it, is the norm for Valdez, Alaska.

Think snow—360 inches of snow to be Now you can picture Valdez, Alaska. spill 25 miles away never reached Valdez—the exact. Snow the height of a 30-story building But Lorrie Mott and William Comer oil spill is actually named for the oil tanker and people with shovels, snow blowers, and don’t just think about it. They live it. Exxon Valdez that ran aground—the city snowplows buzzing around like gnats to get Mott is an Emergency Medical Dis - became the center for clean-up operations. rid of the snow before the next storm arrives. patcher for the City of Valdez, which is at Mott’s family moved there when she Think of signing off your CAD, climbing a the head of a deep fjord in the Prince Wil - was four years old. That was more than a ladder, and shoveling the snow off the roof liam Sound most might remember for the decade after the city was nearly destroyed of your communication center, being careful huge and environmentally disastrous oil spill by the 1964 Good Friday Earthquake, forc- not to cover the police chief’s official car. of March 24, 1989. Although the oil from the ing residents to relocate their homes and the

40 THE JOURNAL | iaedjournal.org town four miles farther inland. It was also several years before completion of the Trans- Alaska Pipeline, terminating in Valdez, but just about the same time Comer, the Valdez police chief, decided he no longer wanted to travel the Far North by thumb. “It was 1980 and I was on a mission to hitchhike through Alaska from Washing- ton state,” Comer said. “I ended up staying. There’s no place like it.” Mott and Comer are not only dazzled by the Valdez they remember pre-oil spill but, also, the beauty and adventure that still remain. Comer worked construction and odd jobs for two years, joined the volunteer fire department, and in 1982 was hired full time as a firefighter/EMT. During the past 30 years he Multitasker Paradise Boredom is not a term EMD Lorrie Mott would use to describe her job at the agency. has worked for the city in various capacities leading to his current position heading up the and know how to collect evidence at a crime police department. He and his 10 sworn offi- scene. Mott is the evidence custodian. cers provide the primary law enforcement for Mott enjoys the variety. She even wrote 270 square miles that include the city proper, “There’s always the center’s training manual. four outlying subdivisions, and the terminus “There’s always something going on but of the pipeline. The police department is part something going we’re not as wild west as it sounds,” she said. of a city administrative complex bordered by “We’re all in this together.” grocery and hardware stores, a Valdez history on but we’re not And that includes the snow shoveling. museum, gift shops, outfitters, service shops, a A city emergency was declared during hospital, and schools. as wild west as the 30 days of straight heavy snowfall from Comer likes winter weather and the December 2011 through January 2012. A stability and consequent job mix the small it sounds.” record 19 inches fell one day, shutting down coastal city offers. He polices a population of Richardson Highway—the only highway in about 4,000, which doubles during the tour- and out of Valdez. Despite the city’s big fleet ist season. His department handles about 300 – Lorrie Mott for snow removal, Valdez hired 150 people to criminal and 50 felony cases a year. The clean shovel snow loads exceeding capacity off the up during the oil spill temporarily swelled roofs of every city building. Mott was quick the population to 15,000; the number of to grab a shovel and, intermittently, for the arrests quadrupled. Calls requiring emergency assistance run to next two weeks climbed up onto the roof to “That was a tremendous problem because about 500 a year, while calls for service top save the building from collapsing under the we’re a small operation always trying to max- 5,500. They answer calls common to every weight of accumulating snow. imize what a small staff can do,” Comer said. dispatch center—domestics, drugs, and traffic “All maintenance went to snow removal,” “For the most part Valdez has a positive, pro- accidents—and calls unique to their type of Comer said. “We kept piling it up on the park gressive environment.” environment—bear alerts, moose standoffs, strips and playgrounds.” Mott recalls the “craziness” of a busy town and tourists ill-prepared for conditions and Snow drifting to eight feet high and 272 during pipeline construction, causing her fam- navigationally challenged. inches of total snowfall by January, however, ily to move out, and the way things settled They are computer savvy, going to full did not crush daily routines. Schools opened down enough for her to move back in for the CAD operations in 2006 from a dispatch on time each day, and employees of the Aly- amenities Valdez offers. Mott’s into fitness system relying on notes handwritten during eska Pipeline Service Company went to work and, also, basically anything that has to do phone calls and transmitted over the radios moving oil and removing snow. Snow pushed with the outdoors. She is the dispatch super- to public safety personal and EMS. They to the edge of roads and sidewalks created visor for the police department, although the assist with tactical communications off site white-walled tunnels and canyons. People title far from fits her job description. and, as Mott said, “all other duties as assigned.” unable to leave their homes simply stayed Mott does everything expected and more. They also take on job responsibilities put and took the snow in stride. Dispatch is her primary responsibility, unique to their relatively small operation. Mott admits Valdez isn’t everyone’s of course, but with no lack of jobs lining up The PST staff books prisoners into the 4-cell, dreamscape, and she has a keen sense of the behind her CAD. She and the six full-time 12-bunk jail located in the other wing of the type of people who will last on the job. staff members, known as Public Safety Tech- building, and they clean the cells. They are “We don’t have a lot of turnover,” she said. nicians (PSTs), are cross-trained as dispatch- Taser certified for prisoner transport, pep- “If they like the outdoors and have the ability ers and corrections officers. They answer fire, per spray certified, and firearms qualified. to do more than one thing at a time, they find police, and medical calls and staff the city jail. The PSTs are trained in defensive tactics this a great place to be.” g

THE JOURNAL | March/April 2013 41 g offhours Protocols In Action EMD sculpts 33 figures depicting medical calls

Prank or unintentional misuse “People here make suggestions of 9-1-1 are not laughing matters and I come up with the idea of how at the New Hampshire Bureau of to make it,” she said. “We have a good Emergency Communications but time with this.” one did bring out unknown artistic While McCarty certainly finds talents in an EMD. nothing funny about the emergen- “I’d call this one off-color,” EMD cies the protocols attend to, she has Kathleen McCarty said. “It had to do found the hobby to be a good way with a caller’s indigestion.” to relieve the stress that comes Since the center acknowledges with the job. exceptional events such as child - “She said her doctor recom - birth and delivery with the stork mended something to take her mind lapel pin, fellow dispatchers figured off work,” said Operations Chief why not the same for answering David Rivers. “I don’t think this is calls for other out-of-the ordinary exactly what the doctor meant.” or extraordinary circumstances. McCarty laughs at his comment, McCarty set to work, crafted the although she has found the concen- lapel from clay, and found herself a tration required to work in clay does new and rewarding hobby. help her relax. In keeping with her “I had no idea I had it in me,” sense of humor, she sculpted a figure she said. of Rivers standing in his “we know In the months following her first he’s worried” pose. “release” of the lapel pin, McCarty “He always grabs his left arm like extended her artistry in clay to 33 he’s in stress pain,” she said. action figures, each depicting a medi- Rivers likes the sculptures for cal condition related to the Medical both the artistic merit and the fun Priority Dispatch System™ (MPDS®) they bring into the communication Protocol. Her preferred “sculpting center. He plans to put them on pub- medium” is the polymer clay she finds lic display in the lobby outside the ideal for the detail work each protocol dispatch room. model requires. She buys the clay in “I can’t say I’ve seen anything the multi-color packages and bakes the like this in any other communica - sculpture in an oven until it hardens. tion center,” he said. “And in their The results are impressive. own way, they say a lot about Each sculpture is from one to what we do.” two inches in height. Each is differ- McCarty has worked at the same ent from the next. Some are elabo- agency since entering the profession rate. Some are simply understated. 11 years ago. She likes the variety of The childbirth and delivery figure is emergency dispatch, the multitask- all in one color, while the more coming the work requires, and a job that plicated multi-vehicular traffic acci- lets her help people at the moment dent on a highway bridge involves a no one else can. black and white aircraft, yellow bus, “What we do can affect a big orange and white propane tanker change in a person,” she said. “It truck, and red compact car. feels really good when we can McCarty admits the creativity calm a person while they wait for isn’t all hers. response to arrive.” g

See more of McCarty’s action figures at www.iaedjournal.org

42 THE JOURNAL | iaedjournal.org PLUS, we offer PINS • DRINKWARE • BOOKS • SHIRTS amazing OFFICE GEAR • TOYS • CARDS • GIFTS in-service training that counts towards PSTC – 911 CARES NAED Your one stop shop for great in-service training, continuing Employee appreciation gifts and training via DVD. Visit www.pstc911.com • Call 800-348-8911 education! E-mail [email protected] Visit us at - www.pstc911.com

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Audrey Fraizer

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dessa (Texas) City Mayor Jim Reese right next to Rankin Fite and Tom Bevill, bump on his head from a shallow dive—but knew a good thing when he heard the two Alabama representatives known for the memory stuck. Oabout it and this time, back in 1969, placing and answering the first-ever 9-1-1 call Jones grew up and pursued a degree it was a letter from a constituent telling him on Feb. 16, 1968, in Haleyville (Ala.). aligned with police work, and 12 years into about an article he had read in a recent edi- “9-1-1 is a big deal,” said Jones, executive his chosen field, changes in 9-1-1 administration of Reader’s Digest. director, Ector County (Texas) Emergency tion presented him with a choice. The article—911: A Hot Line for Emergen- Communications District. “A really big deal.” State legislation in 1987 put 9-1-1 ser - cies—published in the December 1968 issue Jones has lived in Odessa for 55 years and vices and the operational funding collected of the popular magazine was written by U.S. as a youngster in the 1960s, he remembers see- under local control. The overall responsi - Rep. J. Edward Roush, an early proponent of ing funeral home station wagons arriving at bility was transferred from the Odessa Fire a three-digit system to summon emergency accidents to pick up the victims. The people Department to the Odessa Police Depart - assistance. Roush’s hometown of Hunting- weren’t dead, but, at that time, there were very ment and its newly formed Computer ton, Okla., made history in March 1968 as Bell few city-owned or privately-owned ambu- Operations Division.1 Telephone’s first-ever 9-1-1 installation; not lance companies. Fire department dispatchers Sgt. Jones and fellow police Lt. Les long afterward, Roush sponsored legislation referred the calls to the local mortuaries. Blalock were transferred to the new divi - to adopt the three-digit number nationally. That bothered Jones, especially after sion, with Jones turning down a promo - Rep. Roush might never make it on any- the time a station wagon picked up his tion to detective in exchange for the task one’s list of American heroes, but to Kevin brother following an accident in a public of revamping the existing program into an Jones he does merit a place in 9-1-1 history swimming pool. His brother was fine—a Enhanced 9-1-1 system. By 1992, the growing

44 THE JOURNAL | iaedjournal.org district and 9-1-1 service required led to hir- Department and answered by officers dou- vides support and training to the two PSAPs ing Blalock and Jones full time along with bling as dispatchers. in Ector County: Odessa Public Safety Com- Administrative Secretary Janet Bean. 2 Odessa became the sixth city in the U.S. munications Center (a primary PSAP) and Blalock retired on Dec. 31, 2009. Jones, and the first city in Texas to offer 9-1-1 services the Ector County Sheriff’s Office dispatch the district’s former operations manager, suc- to its citizens when operations began on April center (a secondary PSAP). ceeded Blalock as executive director. Jones 1, 1970, at an operational cost of $113 a month The dispatchers at the Odessa center are can’t say he never looks back at the decision for the first year; the rate dropped to $59 per EMD certified, and they are in the process of made 25 years ago, but he does enjoy looking month in the subsequent year. getting EFD and EPD certified. back at the history of how his second profes- Participating agencies included the fire According to an article in the book Ector sion came to be. department, police department, public safety County, Texas: 125 Years of History, the district “Mayor Reese read the letter and con - department, sheriff’s department, and ambu- never let up on growth: tacted his city manager [Ronald Neighbors],” lance service. Agencies not connected to the In 1999, there were over 43,000 calls Jones said. “They were a very progressive city contributed $2.50 a month. Southwest- made to 9-1-1, with 32% of the calls coming team. The whole city was. Odessa was one of ern Bell picked up the tab for modifying its from wireless phone lines. In 2005, more than the first cities to own an ambulance service. switching equipment. 57,000 calls were made to 9-1-1, with 53% of I was one of three EMTs in the police depart- Galveston followed their lead 20 days later. the calls coming from wireless phone lines. ment after I graduated from college in 1975 The new emergency system in Odessa For the year 2009, there were 79,914 calls and joined the department.” took some getting used to, although Neigh- made to 9-1-1, with 75% of the calls originat- Reese and Neighbors also saw the poten- bors had heard about people dialing the three ing from wireless phone calls. 5 tial for making a name for Odessa. digits before the 9-1-1 system was actually The district supports several 9-1-1 Neighbors was eager to see Odessa as operational; they were understandably curi- emergency-related projects, including the the first city in Texas to have the 9-1-1 sys - ous and wanted to see how it worked and Red E. Fox Public Education Program and tem installed. It was a prestige thing. Reese whether dispatchers could handle the job of the Annual Telecommunicator of the Year wanted to make it easier for citizens to get transferring calls once reserved for general awards. The district is prepped and ready help in an emergency. He was altruistic. They telephone operators. for NG9-1-1. appointed Assistant City Manager Ernie Reese and his administrators pointed Jones commemorated the district’s 25th Crawford to get the ball rolling. out advantages of a trained dispatcher han- anniversary in 2012 by presenting a challenge “This system will turn every telephone dling the calls and the speed of making a call coin to each member of the Texas 9-1-1 Alli- into a fire alarm box and police station compared to looking up and dialing a seven- ance (an organized group of all Emergency house,” Reese said. “Properly used, the people digit number. Southwestern Bell would con- Communication Districts in the State of of Odessa won’t have to worry about remem- tinue to provide emergency service through Texas). The district’s logo was engraved on bering numbers and wasting time trying to operators, although the phone company one side and the date of the 25th anniversary dial the various emergency agencies.” 3 emphasized 9-1-1 as the fastest method for on the other side. In a preliminary meeting, the police securing emergency aid. “Everyone said they wished they had department, Ector County Sheriff’s Office, Helen Reeves, who in 1977 started her thought of bringing something,” he said. “I ambulance service, fire department, and career as an Odessa Fire Department dis - was glad to be the one that did.” g Texas Highway Patrol seemed genuinely patcher, was honored for 18 years of service excited by the plan to set up a single three- when she retired in 1995. The job’s stress Sources digit emergency number. took its toll on her, she said, but the upside 1 Glenn Justice, Ector County, Texas: 125 Years of History, Texas Jones credits field supervisors from the was saving lives. Historical Publishing Network, Texas; First Edition, 2001, pp. 112-113 Southwestern Bell Telephone Co. for coor- “I was good, and I was quite proud of it,” 2 See Note 1 dinating a service that routed 9-1-1 calls to a she said.4 3 red phone set up in the Odessa Fire Depart- The district designation shifted the tax- Richard Womack, Emergency Phone System Has Prestige Value, The Odessa American, March 24, 1969 ment and answered by firefighters doubling ing structure to a monthly fee paid by phone 4 as dispatchers, who, when necessary, would subscribers. The fees collected today con- Sarah Westbrook, City Emergency Service Program Recog- nized, The Odessa American, Sept. 12, 1995 reroute calls requiring law enforcement to tinue to cover telephone equipment, public 5 the green phone set up at the Odessa Police education, and training. The district also pro- See Note 1

THE JOURNAL | March/April 2013 45 g NEWPRODUCTS

Evans Consoles BOOTH #500

Introducing a new Dispatch™ console from Evans. • Rugged, modular steel and aluminum frame guarantees return on investment • Prewired slatwall design secures cable and wire management at initial install • Front, rear and side access to base equipment enclosures provides maximum accessibility • Revolutionary touchscreen environmental control unit • Compact designs afford better space utilization • Heavy-duty lift columns support single or dual work surfaces with pressure-sensitive safety features • Integrated cable management separates and hides wires while avoiding crimping and pinching As an ISO 9001 Certified Manufacturer, Evans delivers consistent quality, fit and finish on every project. Our commitments to a safe environment for all telecommunicators is evidenced by our GreenGuard certification on the entire console position.

Come visit our booth #500 to view images of the consoles selected for Salt Lake City’s new Public Safety Building!

For more information, visit www.evansonline.com

Global Software BOOTH #311

You Should Expect More. Dispatch Supervisors Expect effortless administration of your call center, whether training new dispatchers, updating map layers, or configuring complex response plans. Dispatchers Expect lightning fast decision making powered by software that learns from you, anticipates your needs, and shows you what you need to see, when you need to see it. Administrators Expect automated, detailed analytics, for better budget planning, and tools to connect your community in new ways to your public safety agencies. IT Staff Expect SQL 2012, with real-time cloud-based backups and failover, a distributed services architecture, and from-the-groundup .NET framework.

Visit booth #311 right now and see how we’ll exceed your expectations.

For more information, visit www.globalsoftwarecorp.com

OnStar BOOTH #307

OnStar works with First Responders to provide exact GPS location and relay critical crash data to help determine resources to send to the scene. Automatic Crash Response in OnStar-equipped vehicles has built-in sensors that can automatically alert an OnStar Advisor if there’s been a crash and Injury Severity Prediction helps to predict if there is a high probability of severe injury. OnStar Advisors can relay this critical crash data to emergency dispatchers to help determine appropriate resources to send to the scene. Even if the occupants can’t respond, OnStar Advisors work with 911 personnel to provide the vehicle’s exact GPS location to help direct them to the scene. EMD-Certified OnStar Advisors can provide emergency medical dispatch instructions to subscribers until first responders arrive. Emergency responders can also be conferenced into the vehicle to speak directly with the injured while OnStar relays helpful crash information. We understand details help you save lives and resources. And like you, we’re committed to helping people when they need it the most.

For more information, www.onstar.com/publicsafety

46 THE JOURNAL | iaedjournal.org g NEWPRODUCTS

Police Legal Science BOOTH #113

911 CDE Online, Reality Based Training from PLS is a reality-based, interactive training platform for Telecommunicators. Each monthly lesson is based on the analysis of two actual 911 calls, referred to as Target Calls. The analysis involves listening to the audio recording of a Target Call and identifying issues unique to the call, followed by an examination of the essential skill sets necessary for the effective handling of the call. Emphasis is placed on visualization, professionalism, and customer service. 911 CDE Online reinforces classroom training and supplements agency-specific practices and protocols. The lessons establish an environment for group learning and intra-departmental discussions about the effective aspects of the call and the aspects that could have been handled differently and better. The final section of each Target Call analysis addresses how the handling of the call impacted the issues of legal liability and public perception. Each lesson requires that the lesson taker pass a 10-question final exam that covers the key concepts of the lesson. The lessons are delivered monthly in a user friendly online format and are affordable for departments of all sizes. IAED™ and APCO have recognized 911 CDE Online training for EMD recertification credits.

For more information, visit www.policelegalsciences.com

® ProQA Paramount BOOTH #511 ® P ARAM O U N T ProQA Adds Active Assailant Protocol ® After intense research and development, Priority Dispatch announces the release of Protocol 136: Active Assailant (Shooter) in the Police Priority ® Dispatch System™ (PPDS®) v4.1a. The new ECHO-level determinant is designed for use in high-risk situations to decrease potential risk to the public and responders and, also, assist police officers in determining the appropriate deployment tactics. P ARAM O U N T Here are some of the protocol’s powerful features: • Response tied to goal of locating the killer(s) as quickly as possible to either contain or neutralize the shooter(s) ® • EPD selects and sends the 136-E-1 Determinant Code during Case Entry P ARAM O U N T • Link to Pre-Arrival Instructions (PAIs) appears within the Key Questions section of the protocol • Key Questions specifically designed to quickly collect the information responders need to address these unique incidents • New suffix “M” for Multiple weapon types to address situations in which an assailant may be ® using more than one weapon P ARAM O U N T • Automatic ProQA code reconfiguration when weapons information is gathered in response to Key Question 1 • PAIs can remove potential victims from the immediate area through actual evacuation or LOCKDOWN instructions • Protocol and PAIs developed with the important assistance of the National Tactical Officers Association

For more information about the protocol and the Active Assailant course, visit www.prioritydispatch.net or call Client Services at 800-363-9127.

Russ Bassett BOOTH #412

Russ Bassett, a leading manufacturer of 911 dispatch furniture consoles, is proud to display the recently introduced Desience Flex at this year’s NAVIGATOR 2013 conference. Desience Flex compliments Russ Bassett’s already widely installed PSAP Desience Console line of dispatch console furniture. Both Desience Flex and Desience Consoles provide public safety communication centers with the most advanced configuration options, technology integration and cable management. Flex as its names implies offers agencies the most flexible PSAP furniture in the market based on budget, technology and configuration requirements.

For more information, visit www.russbassett.com

THE JOURNAL | March/April 2013 47 g NEWPRODUCTS

Smart CAD BOOTH #313

New, intuitive and it’s SMART. The Smart Day Group has worked for the past four years with their colleagues at Priority Dispatch® and Priority Solutions to perfect a total solution for all American emergency C & C centers. The 911 call starts on the Smart, ProQA® Paramount, platinum certified, command and dispatch system seamlessly separating the lights and sirens from low acuity calls. For EMS, the Smart CAD is fully integrated with “Smart Care” an EMS app for iPads available to download free from the iTunes app store. Smart Care app boasts state of the art GPS mapping and tracking with a full HIPAA compliant electronic record for in transit completion and electronic handovers at the ED. Back at the center, Omega calls automatically populate a seamlessly integrated PSIAM/LowCode™ screen for nurse triage with the determinate automatically presenting the most appropriate local service for the nurse to select an endpoint. Upon selection a two-way communication portal fires up for electronic referrals and secure messaging to be transacted between the center and service provider. The Smart package is completed by offering integration for insurance billing, local and national reporting plus analytics as well as automation for controlled data sharing back to the citizens and their regular carers. We all know what we need for the ever increasing demand, we all know we need to get smart and we have all been waiting far too long. Now it is here and it is SMART.

For more information, visit www.smartdaygroup.com

TriTech Software Systems BOOTH #201

While citizens can use any number of internet search engines to quickly access millions of records related to a topic, the same cannot be said for public safety personnel because of the sensitivity of the data they need and the databases where it is stored. TriTech Software Systems proudly introduces TriTech.com IQ, a cloud-based solution which aggregates data from multiple sources for searching, alerting, and reporting. By providing access to 9-1-1, CAD, Records, and Jail data, TriTech.com IQ combines the simplicity of a search bar with a powerful engine that gives users the ability to find data in comments, narratives, structured fields, and user-defined elements using partial words, misspellings, phrases, and alternate names. This eliminates the need for Communications Center staff to look for information in multiple, separate systems. Hosted at Nlets, one of the most secure and established hosting systems in the nation, TriTech.com IQ provides agencies the assurances that access to their software is in compliance with stringent FBI-CJIS policies and data is stored in a facility with a redundant technical infrastructure and 24/7/365 onsite monitoring. TriTech. com IQ eliminates the needs for expensive hardware and resource-intensive maintenance. With TriTech staff managing the software updates and data backups, public safety staff can direct their focus on fulfilling their mission of ensuring the safety, security, and preservation of life and property.

For more information, visit TriTech.com

Xybix Systems, Inc. BOOTH #411

For over 22 years, Xybix has provided innovative, industry leading furniture solutions for the problems faced by Dispatchers, Technicians and Communication Center Managers. Xybix’s workstations comply with recent ergonomic standards, helping users achieve their best performance in a mission critical environment. Unique features not found elsewhere include: • Antimicrobial features – protecting Dispatchers from illness is simple with Xybix’s Airborne Germ Eliminator and Antimicrobial Work Surfaces. • End-to-end cable management – no more cords hanging down and getting unplugged. • Dual height-adjustable work surfaces – the proven combination of sitting and standing increases alertness and reduces the risk of injury. • Focal depth adjustment – patented by Xybix, Rollervision® allows the focal depth adjustment of all workstation monitors with one motion. • Open Footwell Space – Go ahead and stretch out! There are no computers under your workstation. • GreenGuard Indoor Air Quality – Xybix’s workstations have been indoor air quality tested giving Dispatchers a clean healthy environment to work. Xybix prides itself in being the industry leader in ergonomic furniture and continues to innovate for better Form, Function, Health, and Performance.

For more information contact Xybix at www.xybix.com, [email protected] or 1-800-788-2810

48 THE JOURNAL | iaedjournal.org g sponsorprofiles Infor EnRoute PARTNER BOOTH #301

Emergency responders need to get the right resources to the right location right now. For more than 25 years, Infor has provided agencies with fast, comprehensive, and reliable dispatch systems that help you respond quicker and be better prepared. Hundreds of agencies across North America use Infor EnRoute Dispatch, a leading computer-aided dispatch (CAD), records management systems (RMS), mapping, mobile data computing, field-based reporting, and automatic vehicle locating solution to help improve call response times and to provide critical, accurate information quickly. Infor is a ProQA® Platinum-certified CAD vendor for fire, police, and medical dispatch protocols. WIN THE RACE AGAINST TIME®.

For more information, visit www.infor.com, call 813-207-6951, or e-mail [email protected]

Priority Dispatch PARTNER BOOTH #511

Priority Dispatch Corp.™ (PDC™) is the leader in multi-service 9-1-1 dispatch calltaking solutions and is endorsed by the International Academies of Emergency Dispatch®. While many have attempted to provide products and training for communications center calltaking, PDC is the only company to take a comprehensive systems approach. The Priority Dispatch System™ has been in use for over 30 years with substantial, frequent updates. Historical data shows the system reduces the risks to field responders, lowers the cost of emergency services and liability for local governments, and increases the quality of service and citizen satisfaction. The Priority Dispatch System is available in ProQA® software format, which interfaces with most CAD and phone systems, as well as in a cardset format. We also offer AQUA® quality assurance and improvement software, training, consulting, and Academy accreditation support.

For more information, e-mail [email protected], call 800-363-9127, or visit us at www.prioritydispatch.net

TriTech Software Systems PLATINUM BOOTH #201

TriTech Software Systems’ sole focus is public safety software. The company’s experienced team of more than 350 industry experts each contribute, on average, more than a decade of industry experience. TriTech has delivered the most trusted public safety software for over two decades and continues to lead the market with innovative, enterprise-wide solutions for call-taking, dispatch, records management, jail management, analytics and intelligence, field-based reporting, patient care reporting, and billing. For the best end-to-end integrated solution with unparalleled workflow to serve any size and type of agency, join the 2,700+ agency installations serving over 200 million citizens across 7 countries who rely on one company – TriTech Software Systems.

For more information on TriTech, visit www.tritech.com

THE JOURNAL | March/April 2013 49 g sponsorprofiles

GOLD LAW and ORDER

Now celebrating 60 years, LAW and ORDER magazine remains the “go to” publication for top and middle management… offering solutions to the many challenges law enforcement professionals and agencies face today. Whether it’s finding new ways to reduce the number of officers killed in traffic-related incidents; implementing successful strategies for attracting and retaining the best qualified personnel; or reporting on the consolidation of communication centers, LAW and ORDER delivers it all to our loyal 38,000 readers.

For more information, call 800-843-9764, or visit us online at www.hendonpub.com.

GOLD National Emergency Number Association BOOTH #519

The National Emergency Number Association (NENA) serves its members and the greater public safety community as the only professional organization solely focused on 9-1-1 policy, technology, operations, and education issues. The association works with public policy leaders; emergency services and telecommunications industry partners; like-minded public safety associations; and other stakeholder groups to develop and carry out critical programs and initiatives to improve 9-1-1; to facilitate the creation of an IP-based Next Generation 9-1-1 system; and to establish industry leading standards, training, and certifications.

Find out more at www.nena.org

GOLD OnStar BOOTH #307

OnStar, the leading provider of in-vehicle safety, security and communication services, is exhibiting to educate the First Responder community about the vital and life-saving information OnStar can provide to 911 centers. OnStar provides services to over 6 million subscribers in the U.S., Canada and China, and is available on most GM models for 2013. OnStar offers a comprehensive portfolio of safety services, including Automatic Crash Response, Injury Severity Prediction, Emergency Medical Dispatch, Stolen Vehicle Slowdown and Remote Ignition Block. Working together, we can help to save lives and keep our roadways safe.

More information can be found at onstar.com/publicsafety

GOLD Public Safety Training Consultants BOOTH #318

The PSTC “family of companies” is your one stop shop for all of your 9-1-1 and emergency communications needs. Please stop by our booth and learn more about our in-person, in-service training, our amazing 911 CARES project and our innovative DVD based training. PSTC is proud of our many in-service and supervisory workshops. Whether it’s training, appreciation products or DVD’s, PSTC is your answer. Stop by our booth for a FREE training DVD. We are also the only company that offers Gordon Graham training DVDs!

For more information, visit www.pstc911.com

50 THE JOURNAL | iaedjournal.org g exhibitorprofiles Alert Public Safety BCE Nexxia Solutions, Inc. BOOTH #512 BOOTH #210 BCE Nexxia is a Bell Canada company. Bell is Canada’s leading provider of information and communications technology solutions. Bell Alert Public Safety Solutions is delivers innovative technology platforms, coupled with unparalleled a company that has been built to address the demands and ever- connectivity to address the business communications needs of increasing needs of public safety. As a result, Alert PSS has designed, governments and commercial enterprises alike. developed and implemented a state of the art software solution which Bell’s Public Safety Group provides solutions for police, fire and allows data sharing at the highest levels of interoperability. We provide EMS agencies. Our solutions help improve client operating efficiency Next Gen 911, CAD, Mapping, Records and Report Management, and productivity while reducing costs, and ultimately improving public Mobile solutions, and Jail Management. With upgrades and new safety. Bell specializes in integrating to other solutions to meet the advancements provided at no additional cost and unique payment most demanding customer needs. options available, Alert PSS is truly a partner in the industry. For more information, visit www.bell.ca For more information, visit www.alertpss.com CCM™ American Association of BOOTH #111

Poison Control Centers The Communications Center Manager™ BOOTH #207 (CCM) Course, now in its 11th year, is a one- of-a-kind program that presents the latest Poison centers serve Americans throughout management and leadership practices used by emergency service providers around the world. It has proven to be the day and night to provide fast, free, expert successful for business leaders and students in implementing effective advice on poisonings with a confidential and changes in today’s communication center. CCM is structured as an private phone call. We can help you, too. Eighteen accelerated program designed to deliver minimum time investment with percent of calls to poison centers come from maximum results. A small group of up to 40 students progresses through health care professionals including emergency responders and hospital two dynamic, separate weeks of education and training building a lifelong physicians. They call for hospital and pre-hospital treatment advice and network of peers and colleagues. for identification of toxins, drugs, and toxidromes. Let us help you. We give you expert knowledge and immediate answers. For more information, visit www.fitchassoc.com, e-mail [email protected], or call (816) 431-2600 For more information, call 1-800-222-1222 Art That Celebrates CritiCall BOOTH #305 BOOTH #304

Art That Celebrates not only CritiCall pre-employment testing software is designed to measure recognizes the “Unsung Heroes” in our lives but, it also celebrates the dispatcher/calltaker applicants’ job-related behaviors and skills such as people, places, pets, and beliefs that touch our lives every day. data entry, multi-tasking, decision-making, memory recall, map reading, and more. The computerized test, which is virtually self-administering For more information, visit www.artthatcelebrates.com and self-scoring, is used by over 1,200 public safety agencies. Many users have reported a dramatic reduction in turnover and an increase in the productivity of those they hire after adopting CritiCall for their pre-employment testing. Custom Test Writer and Validation Wizard included. NEW! TactiCall customizable dispatcher training software is now available. TactiCall helps assess and train dispatchers on speech and protocols necessary to succeed. Demos available.

For more information, visit www.criticall911.com

THE JOURNAL | March/April 2013 51 g exhibitorprofiles Esri Global Software BOOTH #213 Corporation At Esri, we focus on promoting the value of GIS and its applications BOOTH #311 throughout the world and pay close attention to our users’ needs. We respond to our customers with products that are easy to use, flexible, As a public safety agency, you need technology that can adjust and integrated. to the way that you operate — every day. At Global Software, we Esri’s ArcGIS software empowers you with the knowledge you need connect people with information through proven software solutions such as where to respond, how to get there quickly and safely, and what that evolve over time. Our comprehensive suite of products gives to expect once on scene. The fusion and visualization of dynamic data your frontline responders the critical edge when it matters most, while with geographic data gives you an intuitive picture of what is happening, providing you freedom and flexibility in your own system configuration. providing actionable intelligence. With integrated computer aided dispatch (CAD), records management software (RMS), wireless mobile applications and regional data sharing, Visit www.esri.com to learn more about GIS Global delivers reliable, integrated and timely solutions that ensure a safer community.

For more information visit www.globalsoftwarecorp.com or Evans Consoles e-mail [email protected] today BOOTH #500

With over 9,000 locations installed in the past 30 years, Evans Consoles designs and manufactures furniture and turnkey solutions for International Academies of public safety, government, command and control, and homeland security ® environments. Emergency Dispatch Evans’ worldwide headquarters and 170,000 SF manufacturing plant BOOTH #115 is located in Calgary, Alberta, Canada. Evans US operations centers are located in Washington DC and Grapevine, Texas with a dedicated Public The IAED™ is a non-profit, standard- Safety office in Bainbridge Island, Washington. setting organization promoting safe and effective emergency dispatch services worldwide for 30 years. For more information, visit www.evansconsoles.com Comprised of three allied Academies for medical, fire, and police dispatching, the IAED supports first responder-related research, unified protocol application, legislation for emergency call center regulation, and strengthening the emergency dispatch community through First Watch education, certification, and accreditation. Booth #211 For more information, visit www.emergencydispatch.org FirstWatch is a web based, real-time data analysis and Dashboard software system that allows authorized users to drill down into Charts, Graphs, and Maps featuring detailed statistical trends, patterns and geographic clusters of incident information, all based on user-defined Keystone Public Safety, Inc. criteria. FirstWatch is used every day for Situational Awareness, BOOTH #514 Homeland Security, Health Surveillance, as well as for Operational and Performance monitoring/quality improvement for Public Safety teams. Keystone Public Safety has been

FirstWatch analyzes more than 45,000 real-time records daily (that’s in the public safety market providing Black / 505 Red / 427 Gray one new record every 1.8 seconds) from 9-1-1 (EMS, Fire and Police) dispatch software applications to meet the needs of police and fire CAD systems, ProQA®, RMS, Paramedic ePCR’s, Hospital Emergency departments nation-wide since 1988. Departments, Hospital Diversion systems, Poison Control Centers and Keystone’s staff, is a technically oriented group of professionals more – all in real time, automatically!! who understand the complexities of automating public safety agencies. Clients range in size and scope of application uses, from sites See real world examples at www.FirstWatch.net integrating only a few systems users in a single location, to large multi- jurisdictional, multi-agency sites with numerous remote locations. Keystone authors its application software products using knowledge gained first hand from each new client and installation, and with continuing input from our active users associations.

For more information, visit www.kps.com

52 THE JOURNAL | iaedjournal.org g exhibitorprofiles NationalQ Police Legal Sciences NATIONAL BOOTH #415 BOOTH #113

TM Get the Best of Both Worlds 911 CDE Online, Reality ™ Q Introducing PDC Case Review Based Training from PLSs provides unique reality based training to and Quality Assurance Services. Telecommunicator personnel. Through the analysis and study of actual Backed by IAED™ Standards, 911 emergency calls our lesson takers improve visualization skills, Certification, and Faculty. critical thinking abilities, decision making capacity, professionalism and customer service. 911 CDE Online is cost effective and available The new PDC NATIONALQ™ services levels the Quality Assurance in a user friendly online format. Our ultimate goal is to strengthen the (QA) playing field for all Medical Priority Dispatch System™ licensed capacity of Telecommunicators to enhance the quality of life in the communication centers. communities in which they serve. NATIONALQ gives you immediate tools for implementing an effective, structured QA program backed and supported by the IAED For more information, visit www.policelegalsciences.com using certified IAED EMD-Q® faculty. NATIONALQ was designed with a comprehensive menu of QA services from which you can tailor the “perfect” QA program for your agency without sacrificing your budget or staff! Priority Solutions Inc. BOOTH #315 For more information call 800–363-9127 or visit our website at www.prioritydispatch.net/nationalQ We distribute and support the unique, patented software product LowCode™, which integrates into a single call center platform the most widely used nurse triage algorithms and the most widely used emergency ambulance dispatch protocols and pre-arrival instructions New World Systems software ProQA®. BOOTH #105 EndPoints™ is a fully-integrated Directory of Services software application that interfaces seamlessly with LowCode software, New World Systems is known assisting comm. centers in building a team of community healthcare for its stability and longevity in providers to partner in scheduling appointments; callers are public sector software. More than immediately matched with their closest provider and given directions 1,000 public sector agencies nationwide trust New World’s solutions and advised of wait times. and experience to meet demanding requirements and better serve their communities. Developed from the very beginning to work For more information, call 801-363-9127 ext. 110 or visit www. seamlessly together, New World’s Aegis applications offer unmatched prioritysolutionsinc.com. workflow that reduces data entry and provides fast information and communication across all disciplines for Dispatchers, Officers in the field, Firefighters, EMS, Corrections Officers and Command Staff. With extensive input from a large customer base, New World continues Russ Bassett Corporation to enhance and further integrate CAD, Records, Mobile Computing, BOOTH #412 Corrections, Information Sharing and Decision Support solutions. Russ Bassett Corporation is a For more information, visit www.newworldsystems.com leading designer and manufacturer of Desience Dispatch Consoles for mission-critical public safety communications centers and emergency operations centers. Our reputation for providing the highest quality products is unmatched in the industry. All of our products are made in Plantronics the USA at our state-of-the-art manufacturing facility in Whittier, CA. BOOTH #206 Our team of experts works with end users to provide innovative dispatch center design ideas for today’s technology intensive facilities. Powered by a 50 plus year Our singular focus is to provide our customers the highest quality obsession with perfecting headsets and backed by a worldwide products and services that will enhance the functionality of their network of services and support, Plantronics audio devices have earned dispatch operation. a sound reputation in mission-critical applications. Plantronics holds the exclusive contract with the FAA for ATC headsets, and is a prime For more information, visit www.desience.com supplier for E911, NASA, DoD, the Armed Forces, emergency dispatch services and first responders. We design headsets for day-to-day wear in demanding environments and our expertise is used to ensure that every product we build meets the highest standards of quality and reliability.

For more information, please visit www.plantronics.com/gov

THE JOURNAL | March/April 2013 53 g exhibitorprofiles Schedule Express SunGard Public Sector BOOTH #507 BOOTH #407

ScheduleExpress addresses the A proven leader in public safety and government information complex scheduling problems facing technologies, SunGard Public Sector provides integrated enterprise- emergency services. Unlike other “calendaring” solutions, wide solutions for public safety and justice agencies, city and county ScheduleExpress not only allows you to build and maintain shift-based governments, and non-profits. Our innovative software and services schedules, but it also uniquely automates the absence, trade, overtime, solutions enable public safety agencies to connect departments, training and special assignment processes – from request through officers, telecommunicators, and citizens with information at the point approval – effectively eliminating paperwork, man-power costs and of need. More than 115 million citizens in North America reside in substantially reducing errors, omissions and abuse. communities where SunGard Public Sector products are in use. ScheduleExpress is 100% web-based so there is no hardware to buy SunGard Public Sector software suites include ONESolution for or maintain, and no applications to buy or install. You are up and running in Windows, NaviLine for IBM’s iSeries platform, and the PLUS Series. a few days, not weeks or months. The comprehensive ONESolution product line includes computer-aided Come see why so many agencies are choosing ScheduleExpress for dispatch, records management, jails management, mobile computing, and all their scheduling needs! justice applications, alongside a full enterprise-wide software suite for local government finance, human resources, and community services. For more information, visit informersystems.com For more information, visit www.sungardps.com Smart CAD BOOTH #313 Voice Print International BOOTH #101 Have you heard about Smart Cities where a smart Command & Dispatch system automatically identifies Voice Print International is a leading a Smart citizen’s demographics from that citizen’s own Smart storage developer of mission-critical call and radio safe, seamlessly running ProQA® AMPDS™, dispatching and tracking recording solutions. Since its inception, VPI has been dedicated to mobile units using iPads. Automatically outputting low acuity calls to expanding the capabilities of digital voice recording. Public safety PSIAM or LowCode™ for nurse triage then using their determinates and government agencies benefit from VPI’s non-proprietary, to offer appropriate local service providers, whilst firing up a two-way flexible, software based design. Designed around the familiar, communication portal for onward referrals with a HIPAA compliant EHR. intuitive Microsoft NT/2000/XP operating system and constructed NO! then you need to come to NAVIGATOR and see it in operation. of Commercially Off the Shelf (COTS) hardware, upgrades and Come and see us on the Smart stand number 313. maintenance are simple. VPI is dedicated to providing its clients with For more information, visit www.smartdaygroup.com the industry’s most reliable and flexible voice recording solution, saving them precious time, money and, most importantly, giving them peace of mind. Spillman Technologies For more information, visit www.VPI-corp.com BOOTH #202 Spillman Technologies provides comprehensive Xybix Systems, Inc. public safety software solutions for more than 1000 police departments, sheriff’s offices, BOOTH #411 communications centers, fire departments, and correctional facilities nationwide. Spillman Over the past 20 years, Xybix has specializes in integrated software, including CAD, RMS, Mobile Data & been an innovative leader in providing Field Reporting, Mapping & GIS, Crime Analysis & CompStat, JMS, Fire, ergonomic furniture for mission- Data Sharing, and Personnel & Resources. critical, 24/7 environments. Xybix’s unique, user friendly, ergonomic workstations have top-of-the-line features that include end-to-end cable For more information, visit www.spillman.com management, dual height-adjustable work surfaces, simultaneous monitor adjustment for focal depth, and more. Taking an extra step to ensure safe indoor air quality, Xybix’s GreenGuard® Certified furniture creates a clean and healthy work environment. For better Form, Function, Health and Performance visit Xybix’s booth TODAY!

Call 800.788.2810 or e-mail [email protected] for further information!

54 THE JOURNAL | iaedjournal.org C ontrib u t

Tracey Barron Shawn Messinger Ivan Whitaker

Tracey joined the IAED™ after spending Shawn is a police consultant and Ivan is a medical dispatch consultant nine years with the ambulance service Emergency Police Dispatch instructor with Priority Dispatch Corp. He worked as a paramedic, EMD, dispatcher, for Priority Dispatch Corp.™ He is a as a field and communications lieutenant and education manager. While Tracey former chief deputy for the Okanogan for the Emergency Medical Services still teaches EMD, the majority of her County Sheriff’s Office where he Alliance in Marion County, Fla. He also o time is spent working with European was the director of a combined 9-1-1 worked for the Polk County Sheriff’s agencies on research projects using communications center. During this Office as a dispatch manager. Ivan rs the Priority Dispatch System™. time he oversaw the deployment of a is a paramedic, National Q, EFD, and new CAD and countywide RMS system, EMD instructor. He has a bachelor’s 8 | Academy research a VoIP 9-1-1 phone system, and the in Business with a minor in Human deployments of ProQA® in EMD and Resources and a MBA in Leadership EPD. Shawn was also commander of a with a minor in Organizational multi-jurisdictional SWAT team. Development. He will complete his Ph.D. in Management in 2014. 9 | Police BeAt 10 | LEADERSHIP lingo

JENIFER GOODWIN Brett Patterson

Jenifer is a professional journalist who Brett is an Academics & Standards specializes in issues related to 9-1-1 associate and Medical Council of and emergency medical services. A Standards chair for the IAED. His role former reporter for the Union Tribune involves training, curriculum, protocol newspaper in San Diego, she has standards, quality improvement, served as the associate editor for and research. He is a member of the the highly regarded Best Practices in IAED College of Fellows and Rules Emergency Services newsletter for the Committee. Brett began a career in past three years. EMS communications in 1987. Prior to accepting a position with the IAED, 18 | 9-1-1 education he spent 10 years working in Pinellas County, Fla.

23 | FAQ

THE JOURNAL | March/April 2013 55 get the right information.

ProQA® Paramount structured calltaking means all the right information is gathered.

at the right time.

Faster calltaking time means shorter time to dispatch. to the right people –every call.

That means faster, safer responders and safer communities.